Ticlopidine and Z-tuss DM

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Ticlopidine may increase the blood levels and effects of dextromethorphan. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects such as difficulty breathing, dizziness, drowsiness, difficulty sleeping, or diarrhea. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Coadministration with CYP450 2D6 inhibitors may increase the plasma concentrations of dextromethorphan in patients who are extensive metabolizers of this isoenzyme (approximately 93% of Caucasians and more than 98% of Asians and individuals of African descent). The proposed mechanism is inhibition of the CYP450 2D6-mediated O-demethylation of dextromethorphan. Increased plasma concentrations increase the risk of dextromethorphan-related adverse effects (e.g., agitation, confusion, tremor, insomnia, diarrhea, and respiratory depression) and serotonin syndrome. Coadministration of dextromethorphan (60 mg orally, once) with the CYP450 2D6 inhibitor panobinostat (20 mg orally once a day on days 3, 5, and 8) in 14 patients with advanced cancer had a highly variable effect on dextromethorphan levels, increasing the peak plasma concentration (Cmax) of dextromethorphan by 20% to 200%, and total systemic exposure (AUC 0 to infinity) by 20% to 130%, compared to dextromethorphan given alone. In addition, multiple doses of the potent CYP450 2D6 inhibitor cinacalcet (50 mg daily), increased the AUC of a single 30 mg dextromethorphan dose by 11-fold in extensive metabolizers of this isoenzyme. The moderate CYP450 2D6 inhibitor asunaprevir, given at 200 mg twice daily, also increased Cmax and AUC of a single 30 mg dose of dextromethorphan by 2.7- and 3.9-fold, respectively, in 17 study subjects.

MANAGEMENT: Caution should be exercised if these drugs must be used together. Patients should be monitored for signs of dextromethorphan adverse effects (e.g., agitation, confusion, tremor, insomnia, diarrhea, and respiratory depression) and serotonin syndrome, and advised to notify their health care professional if these adverse effects develop or worsen. Dose reduction of dextromethorphan may also be required.

Ticlopidine

Generic Name: ticlopidine

Brand name: Ticlid

Synonyms: n.a.

What is Ticlopidine?

Z-tuss DM

Generic Name: dextromethorphan / guaifenesin / phenylephrine

Brand name: Broncotron-D, Duravent DM, Giltuss, Mucinex Fast-Max Severe Congestion & Cough, Phlemex Forte, Robitussin Children's Cough & Cold CF, Robitussin Multi-Symptom Cold, Tusicof, Tussin CF, Vanacof DM, Z-tuss DM, Deconex DMX, Maxiphen DM, Tussex, Tussafed-EX, Sinutuss DM, GDP-EX, Duraphen DM, TriTuss, TriTuss-ER, Tussafed-EX Drops, Certuss-D, Dacex-PE, Anextuss, Dexcon-PE, Zotex LAX, Dacex-DM, Dexcon-DM, Duraphen II DM, Duraphen Forte, G-Phen DM, Despec DM Syrup, Phlemex-PE, Guaphen Forte, Guaphen II DM, Z-Dex, Aquatab C, Robafen CF, DuraMAX, Tusso-XR, Tusso-DM, Robitussin Cough & Cold CF, Ambi 40/1000/60, Maxiphen-G DM, Robitussin Pediatric Cough & Cold CF, Deconex DM, PDM GG, ExeTuss-DM, Endacon DM, Giltuss TR, Q-Tussin CF, Tusso-DMR, Execof ER, Dynatuss EX, Zotex, Robitussin Cough & Cold CF To Go, Zotex-EX, Endacon, Robitussin Cough & Cold CF Max, Mucinex Children's Multi-Symptom Cold, Supress-DX, Tussi-Pres, Tussi-Pres Pediatric, Pres Gen Pediatric, Pres Gen, Robitussin Peak Cold Max Strenth Multi-S, G-Tusicof, Adult Severe Congestion & Cough, Giltuss Pediatrics, Desgen DM, G-Supress DX, Tusslin, Desgen Pediatric, G-Tron Ped, Broncotron Ped, Tusslin Pediatric, Nivanex DMX, Relhist DMX, Giltuss Cough & Cold, Children Giltuss Cough & Cold, VanaTab DM, Tukol Cough & Cold, Robitussin Peak Cold Multi-Sympton Cold, Deconex DMX Poly, Tussidex

Synonyms: n.a.

What is Z-tuss DM?