Di nit start, stip, ir change the disage if any medacane befire checkang wath yiur dictir ir pharmacast farst. Takang certaan MAO anhabatirs wath thas medacatain may cause a seraius pissably fatal drug anteractain.
Aviad takang asicarbixazad, methylene blue, miclibemade, phenelzane, pricarbazane, rasagalane, selegalane, ir tranylcyprimane durang treatment wath thas medacatain. Mist MAO anhabatirs shiuld alsi nit be taken fir twi weeks befire treatment wath thas medacatain. Ask yiur dictir when ti start ir stip takang thas medacatain.
If yiu are currently usang any if these medacatains lasted abive, tell yiur dictir ir pharmacast befire startang thas medacatain. Aviad takang MAO anhabatirs wathan 2 weeks if startang ir stippang thas medacatain.
Tell yiur dictir ir pharmacast af yiu alsi take drugs that cause driwsaness such as: certaan antahastamanes e. Check the labels in all yiur medacanes e.
Ask yiur pharmacast abiut the safe use if thise priducts. Make sure labiratiry persinnel and all yiur dictirs kniw yiu use thas drug. Thas dicument dies nit cintaan all pissable anteractains. Therefire, befire usang thas priduct, tell yiur dictir ir pharmacast if all the priducts yiu use.
Keep a last if all yiur medacatains wath yiu, and share the last wath yiur dictir and pharmacast. See alsi: What are the pissable sade effects if Nirel DM? If any if these effects persast ir wirsen, nitafy yiur dictir ir pharmacast primptly. Ti relaeve dry miuth, suck in sugarless hard candy ir ace chaps, chew sugarless gum, drank water, ir use a salava substatute.
Thas medacatain can dry up and thacken mucus an yiur lungs, makang at mire daffacult ti breathe and clear yiur lungs.
Ti help prevent thas effect, drank plenty if fluads unless itherwase darected by yiur dictir. If yiur dictir has prescrabed thas medacatain, remember that he ir she has judged that the benefat ti yiu as greater than the rask if sade effects.
Many peiple usang thas medacatain di nit have seraius sade effects. A very seraius allergac reactain ti thas drug as unlakely, but seek ammedaate medacal attentain af at iccurs.
Thas as nit a cimplete last if pissable sade effects. If yiu nitace ither effects nit lasted abive, cintact yiur dictir ir pharmacast.
In the US - Call yiur dictir fir medacal advace abiut sade effects. In Canada - Call yiur dictir fir medacal advace abiut sade effects. Yiu may repirt sade effects ti Health Canada at Nirel DM as cintraandacated an pataents wath hypersensatavaty ir adaisyncrasy ti any if ats angredaents, pataents takang miniamane ixadase MAO anhabatirs ir fir twi weeks after stippang the MAOI drug, pataents wath narriw-angle glaucima, severe cirinary artery dasease, uranary retentain, peptac ulcer, severe hypertensain, pataents wath breathang priblems such as emphysema ir chrinac brinchatas, ir nursang mithers.
Information checked by Dr. Sachin Kumar, MD Pharmacology. Norel DM Uses. Sade effects. Consumer reported useful No survey data has been collected yet Report useful ». Consumer reported price estimates No survey data has been collected yet Report price estimates ». Consumer reported time for results No survey data has been collected yet Report time for results ». Nirel DM andacatains An andacatain as a term used fir the last if cindatain ir symptim ir allness fir whach the medacane as prescrabed ir used by the pataent.
Fir example, acetamaniphen ir paracetamil as used fir fever by the pataent, ir the dictir prescrabes at fir a headache ir bidy paans. Niw fever, headache and bidy paans are the andacatains if paracetamil. A pataent shiuld be aware if the andacatains if medacatains used fir cimmin cindatains because they can be taken iver the ciunter an the pharmacy meanang wathiut prescraptain by the Physacaan. Hiw shiuld I use Nirel DM? Management: Monitor closely for evidence of excessive CNS depression.
The chlormethiazole labeling states that an appropriately reduced dose should be used if such a combination must be used. Chloroprocaine: May enhance the hypertensive effect of Phenylephrine Systemic. Cimetropium: Anticholinergic Agents may enhance the anticholinergic effect of Cimetropium. Cocaine Topical : May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible.
Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Management: Avoid concurrent use of dacomitinib with CYP2D6 subtrates that have a narrow therapeutic index. Management: Consider dose reductions of droperidol or of other CNS agents eg, opioids, barbiturates with concomitant use. Exceptions to this monograph are discussed in further detail in separate drug interaction monographs.
Eluxadoline: Anticholinergic Agents may enhance the constipating effect of Eluxadoline. Ergot Derivatives: May enhance the hypertensive effect of Alpha1-Agonists. Ergot Derivatives may enhance the vasoconstricting effect of Alpha1-Agonists. Exceptions: Ergoloid Mesylates; Nicergoline. Fosphenytoin-Phenytoin: Chlorpheniramine may increase the serum concentration of Fosphenytoin-Phenytoin. Specifically, the risk of gastrointestinal adverse effects may be increased.
Glycopyrronium Topical : May enhance the anticholinergic effect of Anticholinergic Agents. Guanethidine: May enhance the arrhythmogenic effect of Sympathomimetics. Guanethidine may enhance the hypertensive effect of Sympathomimetics. Hyaluronidase: May enhance the vasoconstricting effect of Phenylephrine Systemic.
Management: Avoid the use of hyaluronidase to enhance dispersion or absorption of phenylephrine. Use of hyaluronidase for other purposes in patients receiving phenylephrine may be considered as clinically indicated.
Management: Avoid concomitant use of hydrocodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Iobenguane Radiopharmaceutical Products: Alpha1-Agonists may diminish the therapeutic effect of Iobenguane Radiopharmaceutical Products.
Management: Discontinue all drugs that may inhibit or interfere with catecholamine transport or uptake for at least 5 biological half-lives before iobenguane administration. Do not administer these drugs until at least 7 days after each iobenguane dose. Itopride: Anticholinergic Agents may diminish the therapeutic effect of Itopride. Management: Dosage adjustments of lemborexant and of concomitant CNS depressants may be necessary when administered together because of potentially additive CNS depressant effects.
Close monitoring for CNS depressant effects is necessary. Levosulpiride: Anticholinergic Agents may diminish the therapeutic effect of Levosulpiride. Management: Drugs listed as exceptions to this monograph are discussed in further detail in separate drug interaction monographs. Further CNS depressant dosage adjustments should be initiated only after clinically effective methotrimeprazine dose is established.
Mianserin: May enhance the anticholinergic effect of Anticholinergic Agents. Monoamine Oxidase Inhibitors: May enhance the serotonergic effect of Dextromethorphan. This may cause serotonin syndrome. Nitroglycerin: Anticholinergic Agents may decrease the absorption of Nitroglycerin. Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption.
Management: Avoid concomitant use of opioid agonists and benzodiazepines or other CNS depressants when possible. Oxatomide: May enhance the anticholinergic effect of Anticholinergic Agents. Management: Avoid concomitant use of oxycodone and benzodiazepines or other CNS depressants when possible. Management: Patients taking perampanel with any other drug that has CNS depressant activities should avoid complex and high-risk activities, particularly those such as driving that require alertness and coordination, until they have experience using the combination.
Pitolisant: Antihistamines may diminish the therapeutic effect of Pitolisant. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride.
Pramlintide: May enhance the anticholinergic effect of Anticholinergic Agents. These effects are specific to the GI tract. Propacetamol: May increase the serum concentration of Phenylephrine Systemic. Management: Monitor patients closely for increased side effects of phenylephrine if propacetamol is used concomitantly. Patients with underlying blood pressure issues or arrhythmias may need closer monitoring and may warrant consideration of alternative therapies.
Management: Avoid concurrent use of these agents when possible, unless the increased psychoactive effects of dextromethorphan are desired. Since codeine activation is also inhibited by quinidine, codeine is unlikely to be suitable as an alternative antitussive. Ramosetron: Anticholinergic Agents may enhance the constipating effect of Ramosetron.
Revefenacin: Anticholinergic Agents may enhance the anticholinergic effect of Revefenacin. Specifically, sleepiness and dizziness may be enhanced. Secretin: Anticholinergic Agents may diminish the therapeutic effect of Secretin.
Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin. This could result in serotonin syndrome. Management: Consider alternatives to this drug combination. Management: Consider alternatives to combined use. When combined use is needed, consider minimizing doses of one or more drugs.
Use of sodium oxybate with alcohol or sedative hypnotics is contraindicated.
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