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Tussin DM and Zofran (Ondansetron Oral Solution)

Determining the interaction of Tussin DM and Zofran (Ondansetron Oral Solution) and the possibility of their joint administration.

Check result:
Tussin DM <> Zofran (Ondansetron Oral Solution)
Relevance: 26.04.2023 Reviewer: Shkutko P.M., M.D., in

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.

Consumer:

Using ondansetron together with dextromethorphan can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. 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.

Professional:

MONITOR CLOSELY: Concomitant use of 5-HT3 receptor antagonists with agents that possess or enhance serotonergic activity such as selective serotonin reuptake inhibitors (SSRIs), selective serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), 5-HT1 receptor agonists (triptans), ergot alkaloids, phenylpiperidine opioids, bupropion, dextromethorphan, linezolid, lithium, St. John's wort, tramadol, and tryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. According to the manufacturers, development of serotonin syndrome has been reported with 5-HT3 receptor antagonists, primarily during concomitant use of serotonergic drugs but also in overdose. Some of the reported cases were fatal. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucination, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.

MANAGEMENT: Caution is advised if 5-HT3 receptor antagonists are prescribed with other agents that affect the serotonergic neurotransmitter system. Patients should be closely monitored for symptoms of the serotonin syndrome during treatment. Particular caution is warranted when initiating or increasing the dosages of these agents. The potential risk for serotonin syndrome should be considered even when administering serotonergic agents sequentially, as some agents may demonstrate a prolonged elimination half-life. For example, a 5-week washout period is typically recommended following use of fluoxetine and 2 weeks following use of MAOIs before administering another serotonergic agent. If serotonin syndrome develops or is suspected during the course of therapy, all serotonergic agents should be discontinued immediately and supportive care rendered as necessary. Moderately ill patients may also benefit from the administration of a serotonin antagonist (e.g., cyproheptadine, chlorpromazine). Severe cases should be managed under consultation with a toxicologist and may require sedation, neuromuscular paralysis, intubation, and mechanical ventilation in addition to the other measures.

References
  • "Product Information. Akynzeo (netupitant-palonosetron)." Eisai Inc, Woodcliff Lake, NJ.
  • Cerner Multum, Inc. "Australian Product Information." O 0
  • Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  • Canadian Pharmacists Association "e-CPS. Available from: URL: http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink."
  • "Product Information. Sancuso (granisetron)." ProStrakan Group, Bedminster, NJ.
  • "Product Information. Aloxi (palonosetron)." MGI Pharma Inc, Minnetonka, MN.
  • "Product Information. Anzemet (dolasetron)." Hoechst Marion-Roussel Inc, Kansas City, MO.
Tussin DM

Generic Name: dextromethorphan / guaifenesin

Brand name: Aquatab DM, Broncotron, Coricidin HBP Chest Congestion & Cough, DayQuil Mucus Control DM, Delsym Cough Plus Chest Congestion DM, Fenesin DM IR, G-Zyncof, Mucinex DM, Phlemex, Robitussin Cough + Chest Congestion DM, Safetussin DM, Siltussin DM, TabTussin DM, Tussin DM, Zyncof, Bidex-A, Guaifenex DM, Biospec DMX, Robitussin DM, Mucinex Cough Mini-Melts, Tussi-Organidin DM-S NR, Tussi-Organidin DM NR, Gani-Tuss-DM NR, Guaibid DM, Muco-Fen DM, Guiadrine DM, Fenex-DM, Iobid DM, Q-Bid DM, Aquabid DM, Touro DM, Respa-DM, Mucobid DM, Fenesin DM, Humibid DM Pediatric, Iofen-DM NF, Phanatuss, Naldecon Senior DX, Guiatussin-DM, Halotussin DM, Guiatuss DM, Halotussin DM Sugar Free, Rhinosyn-DMX, Tuss-DM, Kolephrin GG/DM, Cheracol D Cough, Genatuss DM, Glycotuss-DM, Mytussin DM, Tolu-Sed DM, Benylin Expectorant, Vicks 44E Pediatric, Guiacough DM, Lotussin DM, Anti-Tuss DM, Biotuss DM, Cheracol-D, GG/DM, Mastussin DM, Recofen D, Recofen Plus, Ri-Tussin DM, Robafen DM, Robichem DM, T-Tussin DM, Tusscidin DM, Bidex-DM, Diabetic Suppressant, Duraganidin, G Bid DM, GG-DM SR, Humigen DM, Tussidin DM, Altarussin DM, Amibid DM, Guiat Clear DM, Cough Formula-DM, Double-Tussin DM, Guaiasorb Cough Medicine, Kita La Tos, Q-Tussin DM, Scot-Tussin DM, Nalspan Senior DX, Diabetic Tuss DM, Vicks 44E, Scot-Tussin Senior, Naldecon DX Liquigel, Safetussin 30 DM, Duratuss DM, Guiatuss Clear, Iophen DM NR, Allfen-DM, S-Pack DM, HT Tuss DM, Monafed DM, Hydro-Tuss DM, Drituss DM, Liquibid-D LA, Guaifen DM, Maxi-Tuss DM, Robitussin-SF, Su-Tuss DM, Muco-Fen 800 DM, Guai-Dex, GuaiFENesin DM, GuaiFENesin DM SR, Tussi-Bid, Sudal DM, Iophen DM, Ru-Tuss 800 DM, Mintab DM, Mindal DM, Atuss-12 DX, Z-Cof LA, Extuss LA, DuraDEX, Humibid CS, Diabetic Tuss DM Maximum Strength, Siltussin DM DAS Cough Formula, Simuc-DM, Cofex-DM, Mucus Relief DM, G-Bid DM, Relacon LAX, Ambi 1000/55, Z-Cof LAX, Robafen DM Clear, DuraDEX Forte, Robitussin DM Infant Drops, Zotex DMX, Mucinex Children's Cough, Duratuss DM 12, Robitussin Cough Sugar-Free DM, Dex-Tuss DM, Mucinex DM Maximum Strength, GuaiFENesin DM NR, Children's Mucus Relief Cough, Siltussin-DM DAS-NA, Siltussin-DM DAS-NA Maximum Strength, ExeFen-DM, Bidex-DMI, Mucinex Children's Cough Mini-Melts, Robitussin Cough & Cong, Coricidin HBP Congestion/Cough

Synonyms: n.a.

Zofran (Ondansetron Oral Solution)

Generic Name: ondansetron

Brand name: Zofran, Zofran ODT, Zuplenz

Synonyms: Zofran

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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