Paracetamol + Caffeine interactions

Food & lifestyle

• alcohol

  Major

  Metabolism

  Chronic, excessive consumption of alcohol may increase the risk of acetaminophen-induced hepatotoxicity, which has included rare cases of fatal hepatitis and frank hepatic failure requiring liver transplantation. The proposed mechanism is induction of hepatic microsomal enzymes during chronic alcohol use, which may result in accelerated metabolism of acetaminophen and increased production of potentially hepatotoxic metabolites.

  What to do: In general, chronic alcoholics should avoid regular or excessive use of acetaminophen. Alternative analgesic/antipyretic therapy may be appropriate in patients who consume three or more alcoholic drinks per day. However, if acetaminophen is used, these patients should be cautioned not to exceed the recommended dosage (maximum 4 g/day in adults and children 12 years of age or older).

  12 sources

  1. Kaysen GA, Pond SM, Roper MH, Menke DJ, Marrama MA "Combined hepatic and renal injury in alcoholics during therapeutic use of acetaminophen." Arch Intern Med 145 (1985): 2019-23
  2. O'Dell JR, Zetterman RK, Burnett DA "Centrilobular hepatic fibrosis following acetaminophen-induced hepatic necrosis in an alcoholic." JAMA 255 (1986): 2636-7
  3. Seeff LB, Cuccherini BA, Zimmerman HJ, Adler E, Benjamin SB "Acetaminophen hepatotoxicity in alcoholics." Ann Intern Med 104 (1986): 399-404
  4. Thummel KE, Slattery JT, Nelson SD "Mechanism by which ethanol diminishes the hepatotoxicity of acetaminophen." J Pharmacol Exp Ther 245 (1988): 129-36
  5. McClain CJ, Kromhout JP, Peterson FJ, Holtzman JL "Potentiation of acetaminophen hepatotoxicity by alcohol." JAMA 244 (1980): 251-3
  6. Kartsonis A, Reddy KR, Schiff ER "Alcohol, acetaminophen, and hepatic necrosis." Ann Intern Med 105 (1986): 138-9
  7. Prescott LF, Critchley JA "Drug interactions affecting analgesic toxicity." Am J Med 75 (1983): 113-6
  8. "Product Information. Tylenol (acetaminophen)." McNeil Pharmaceutical (2002):

  Show all 12 sourcesShow fewer sources

  9. Whitcomb DC, Block GD "Association of acetaminopphen hepatotoxicity with fasting and ethanol use." JAMA 272 (1994): 1845-50
  10. Bonkovsky HL "Acetaminophen hepatotoxicity, fasting, and ethanol." JAMA 274 (1995): 301
  11. Nelson EB, Temple AR "Acetaminophen hepatotoxicity, fasting, and ethanol." JAMA 274 (1995): 301
  12. Zimmerman HJ, Maddrey WC "Acetaminophen (paracetamol) hepatotoxicity with regular intake of alcohol: analysis of instances of therapeutic misadventure." Hepatology 22 (1995): 767-73

• grapefruit juice

  Minor

  Metabolism

  The effect of grapefruit juice on the pharmacologic activity of caffeine is controversial. One report suggests that grapefruit juice increases the effect of caffeine. The proposed mechanism is inhibition of cytochrome P-450 metabolism of caffeine.

  What to do: The clinical significance of this potential interaction is unknown.

  2 sources

  1. "Grapefruit juice interactions with drugs." Med Lett Drugs Ther 37 (1995): 73-4
  2. Maish WA, Hampton EM, Whitsett TL, Shepard JD, Lovallo WR "Influence of grapefruit juice on caffeine pharmacokinetics and pharmacodynamics." Pharmacotherapy 16 (1996): 1046-52

Conditions

Conditions in which Paracetamol + Caffeine needs care, as documented in this source.

• Alcoholism

  Major

  Chronic alcohol abusers may be at increased risk of hepatotoxicity during treatment with acetaminophen (APAP). Severe liver injury, including cases of acute liver failure resulting in liver transplant and death, has been reported in patients using acetaminophen. Therapy with acetaminophen should be administered cautiously, if at all, in patients who consume three or more alcoholic drinks a day. In general, patients should avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure. They should also be advised to seek medical attention if they experience signs and symptoms of liver injury such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice.

  11 sources

  1. Kaysen GA, Pond SM, Roper MH, Menke DJ, Marrama MA "Combined hepatic and renal injury in alcoholics during therapeutic use of acetaminophen." Arch Intern Med 145 (1985): 2019-23
  2. O'Dell JR, Zetterman RK, Burnett DA "Centrilobular hepatic fibrosis following acetaminophen-induced hepatic necrosis in an alcoholic." JAMA 255 (1986): 2636-7
  3. Seeff LB, Cuccherini BA, Zimmerman HJ, Adler E, Benjamin SB "Acetaminophen hepatotoxicity in alcoholics." Ann Intern Med 104 (1986): 399-404
  4. McClain CJ, Kromhout JP, Peterson FJ, Holtzman JL "Potentiation of acetaminophen hepatotoxicity by alcohol." JAMA 244 (1980): 251-3
  5. Kartsonis A, Reddy KR, Schiff ER "Alcohol, acetaminophen, and hepatic necrosis." Ann Intern Med 105 (1986): 138-9
  6. Prescott LF, Critchley JA "Drug interactions affecting analgesic toxicity." Am J Med 75 (1983): 113-6
  7. "Product Information. Tylenol (acetaminophen)." McNeil Pharmaceutical (2002):
  8. Whitcomb DC, Block GD "Association of acetaminopphen hepatotoxicity with fasting and ethanol use." JAMA 272 (1994): 1845-50

  Show all 11 sourcesShow fewer sources

  9. Bonkovsky HL "Acetaminophen hepatotoxicity, fasting, and ethanol." JAMA 274 (1995): 301
  10. Nelson EB, Temple AR "Acetaminophen hepatotoxicity, fasting, and ethanol." JAMA 274 (1995): 301
  11. Zimmerman HJ, Maddrey WC "Acetaminophen (paracetamol) hepatotoxicity with regular intake of alcohol: analysis of instances of therapeutic misadventure." Hepatology 22 (1995): 767-73

• Heart Diseases

  Major

  The use of CNS stimulants is contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in adults and children taking CNS stimulant treatment. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.

  13 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Provigil (modafinil)." Cephalon, Inc (2001):
  3. "Product Information. Dopram (doxapram)." West Ward Pharmaceutical Corporation (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  7. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  8. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):

  Show all 13 sourcesShow fewer sources

  9. "Product Information. Concerta (methylphenidate)." Alza (2002):
  10. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
  11. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):
  12. "Product Information. Nuvigil (armodafinil)." Cephalon Inc (2007):
  13. "Product Information. Phendimetrazine Tartrate SR (phendimetrazine)." Sandoz Inc (2012):

• Hypertension

  Major

  CNS stimulant medications have shown to increase blood pressure, and their use might be contraindicated in patients with severe hypertension. Caution should be used when administering to patients with preexisting high blood pressure and other cardiovascular conditions. All patients under treatment should be regularly monitored for changes in blood pressure and heart rate.

  13 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Provigil (modafinil)." Cephalon, Inc (2001):
  3. "Product Information. Dopram (doxapram)." West Ward Pharmaceutical Corporation (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  7. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  8. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):

  Show all 13 sourcesShow fewer sources

  9. "Product Information. Concerta (methylphenidate)." Alza (2002):
  10. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
  11. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):
  12. "Product Information. Nuvigil (armodafinil)." Cephalon Inc (2007):
  13. "Product Information. Phendimetrazine Tartrate SR (phendimetrazine)." Sandoz Inc (2012):

• Liver Diseases

  Major

  Acetaminophen is primarily metabolized in the liver to inactive forms. However, small quantities are converted by minor pathways to metabolites that can cause hepatotoxicity or methemoglobinemia. Patients with hepatic impairment may be at increased risk of toxicity due to increased minor metabolic pathway activity. Likewise, chronic or overuse of acetaminophen can saturate the primary hepatic enzymes and lead to increased metabolism by minor pathways. Severe liver injury, including cases of acute liver failure resulting in liver transplant and death, has been reported in patients using acetaminophen. Therapy with acetaminophen should be administered cautiously in patients with hepatic insufficiency. Clinical monitoring of hepatic function is recommended. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

  6 sources

  1. Gillette JR "An integrated approach to the study of chemically reactive metabolites of acetaminophen." Arch Intern Med 141 (1981): 375-9
  2. Arnman R, Olsson R "Elimination of paracetamol in chronic liver disease." Acta Hepatogastroenterol (Stuttg) 25 (1978): 283-6
  3. Clements JA, Critchley JA, Prescott LF "The role of sulphate conjugation in the metabolism and disposition of oral and intravenous paracetamol in man." Br J Clin Pharmacol 18 (1984): 481-5
  4. Forrest JA, Adriaenssens P, Finlayson ND, Prescott LF "Paracetamol metabolism in chronic liver disease." Eur J Clin Pharmacol 15 (1979): 427-31
  5. Venkataramanan R, Kalp K, Rabinovitch M, et al. "Conjugative drug metabolism in liver transplant patients." Transplant Proc 21 (1989): 2455
  6. "Product Information. Tylenol (acetaminophen)." McNeil Pharmaceutical (2002):

• Liver Diseases

  Major

  In general, CNS stimulants are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with CNS stimulants should be administered cautiously in patients with moderate to severe liver disease, and the dosage should be adjusted accordingly. Additionally, postmarketing reports have shown that atomoxetine can cause severe liver injury. Laboratory testing should be done at the first sign or symptom of liver dysfunction (jaundice, dark urine, upper quadrant tenderness) and treatment should be discontinued in patients with evidence of liver injury.

  13 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Provigil (modafinil)." Cephalon, Inc (2001):
  3. "Product Information. Dopram (doxapram)." West Ward Pharmaceutical Corporation (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  7. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  8. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):

  Show all 13 sourcesShow fewer sources

  9. "Product Information. Concerta (methylphenidate)." Alza (2002):
  10. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
  11. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):
  12. "Product Information. Nuvigil (armodafinil)." Cephalon Inc (2007):
  13. "Product Information. Phendimetrazine Tartrate SR (phendimetrazine)." Sandoz Inc (2012):

• Mental Disorders

  Major

  The use of CNS stimulants can cause psychotic or maniac symptoms, suicidal ideation, aggression and can exacerbate symptoms of behavior disturbance and thought disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders, and all patients should be monitored closely, specially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. All patients receiving treatment should be screened for bipolar disease prior to initiation. If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. CNS stimulants are contraindicated in patients with marked agitation or anxiety.

  13 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Provigil (modafinil)." Cephalon, Inc (2001):
  3. "Product Information. Dopram (doxapram)." West Ward Pharmaceutical Corporation (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  7. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  8. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):

  Show all 13 sourcesShow fewer sources

  9. "Product Information. Concerta (methylphenidate)." Alza (2002):
  10. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
  11. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):
  12. "Product Information. Nuvigil (armodafinil)." Cephalon Inc (2007):
  13. "Product Information. Phendimetrazine Tartrate SR (phendimetrazine)." Sandoz Inc (2012):

• Peptic Ulcer

  Major

  Methylxanthines are known to stimulate peptic acid secretion. Therapy with products containing methylxanthines should be administered with extreme caution in patients with active peptic ulcer disease. Some manufacturers consider their use to be contraindicated under such circumstance.

  4 sources

  1. Stoller JL "Oesophageal ulceration and theophylline." Lancet 2 (1985): 328-9
  2. "Product Information. Theo-Dur (theophylline)." Schering Corporation (2001):
  3. Alterman P, Spiegel D, Feldman J, Yaretzky A "Histamine h2-receptor antagonists and chronic theophylline toxicity." Am Fam Physician 54 (1996): 1473
  4. "Product Information. Lufyllin (dyphylline)." Wallace Laboratories (2001):

• Water-Electrolyte Imbalance

  Major

  Sodium chloride can induce sodium and water retention and result in hypernatremia, hypokalemia, edema and aggravation of congestive heart failure. Therapy with sodium- containing agents should be administered with extreme caution, if at all, in patients with congestive heart failure, severe renal insufficiency, and in clinical states where there is edema with sodium retention. Clinical monitoring of acid/base balance and electrolytes prior to, during, a following completion of therapy with sodium- containing agents is recommended.

  3 sources

  1. "Product Information. Megace (megestrol)." Bristol-Myers Squibb (2001):
  2. "Product Information. Calcibind (cellulose sodium phosphate)." Mission Pharmacal Company (2001):
  3. "Product Information. Sodium Benzoate (sodium benzoate)." Taylor Pharmaceuticals (2001):

• Acid-Base Imbalance

  Moderate

  Sodium benzoate is structurally similar to salicylates and mild respiratory alkalosis may occur. Therapy with sodium benzoate should be administered cautiously in patients with or predisposed to respiratory acidosis.

  1 source

  1. "Product Information. Sodium Benzoate (sodium benzoate)." Taylor Pharmaceuticals (2001):

• Bipolar Disorder

  Moderate

  Central nervous system (CNS) stimulants may induce a mixed/manic episode in patients with bipolar disorder. Prior to initiating treatment, screen patients for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or a family history of suicide, bipolar disorder, and depression). Close monitoring is recommended when using these agents in patients with bipolar disorders.

  12 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Cylert (pemoline)." Abbott Pharmaceutical (2001):
  3. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc (2001):
  7. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  8. "Product Information. Prelu-2 (phendimetrazine)." Boehringer-Ingelheim (2001):

  Show all 12 sourcesShow fewer sources

  9. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  10. "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals (2001):
  11. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
  12. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):

• Cardiotoxicity

  Moderate

  Like other methylxanthines, caffeine at high dosages may be associated with positive inotropic and chronotropic effects on the heart. Caffeine may also produce an increase in systemic vascular resistance, resulting in elevation of blood pressure. Therapy with products containing caffeine should be administered cautiously in patients with severe cardiac disease, hypertension, hyperthyroidism, or acute myocardial injury. Some clinicians recommend avoiding caffeine in patients with symptomatic cardiac arrhythmias and/or palpitations and during the first several days to weeks after an acute myocardial infarction.

  1 source

  1. "Multum Information Services, Inc. Expert Review Panel"

• Epilepsy

  Moderate

  Due to general central nervous system stimulation, therapy with CNS stimulant drugs may cause seizures. These drugs may lower the convulsive threshold in patients with prior history of seizures or EEG abnormalities, and very rarely in patients with no previous history of seizures. Therapy with CNS stimulants should be used with caution in patients with or predisposed to seizures. If seizures appear, therapy should be discontinued.

  13 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Provigil (modafinil)." Cephalon, Inc (2001):
  3. "Product Information. Cylert (pemoline)." Abbott Pharmaceutical (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  7. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  8. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):

  Show all 13 sourcesShow fewer sources

  9. "Product Information. Concerta (methylphenidate)." Alza (2002):
  10. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
  11. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):
  12. "Product Information. Nuvigil (armodafinil)." Cephalon Inc (2007):
  13. "Product Information. Phendimetrazine Tartrate SR (phendimetrazine)." Sandoz Inc (2012):

• Gastroesophageal Reflux

  Moderate

  Methylxanthines increase gastric acidity and may also relax lower esophageal sphincter, which can lead to gastric reflux into the esophagus. Therapy with products containing methylxanthines should be administered cautiously in patients with significant gastroesophageal reflux.

  4 sources

  1. Stoller JL "Oesophageal ulceration and theophylline." Lancet 2 (1985): 328-9
  2. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  3. Alterman P, Spiegel D, Feldman J, Yaretzky A "Histamine h2-receptor antagonists and chronic theophylline toxicity." Am Fam Physician 54 (1996): 1473
  4. "Product Information. Lufyllin (dyphylline)." Wallace Laboratories (2001):

• Kidney Diseases

  Moderate

  Overall CNS stimulants should be administered with caution in patients with significantly impaired renal function as the reduction in the rate of elimination may alter the therapeutic response. The dosage should be adjusted accordingly.

  5 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Provigil (modafinil)." Cephalon, Inc (2001):
  3. "Product Information. Dopram (doxapram)." West Ward Pharmaceutical Corporation (2001):
  4. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  5. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):

• Peptic Ulcer

  Moderate

  Sodium benzoate is structurally similar to salicylates and exacerbation of peptic ulcers may occur. Therapy with sodium benzoate should be administered cautiously in patients with or predisposed to peptic ulcer disease.

  1 source

  1. "Product Information. Sodium Benzoate (sodium benzoate)." Taylor Pharmaceuticals (2001):

• Phenylketonurias

  Moderate

  Several oral acetaminophen and acetaminophen-combination products, particularly flavored chewable tablets, contain the artificial sweetener, aspartame (NutraSweet). Aspartame is converted to phenylalanine in the gastrointestinal tract following ingestion. Chewable and effervescent formulations of acetaminophen products may also contain phenylalanine. The aspartame/phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

  1 source

  1. "Product Information. Tylenol (acetaminophen)." McNeil Pharmaceutical (2002):

• Psychotic Disorders

  Moderate

  Central nervous system (CNS) stimulants may exacerbate symptoms of behavior disturbance and thought disorder in patients with a preexisting psychotic disorder. Close monitoring is recommended when using these agents in patients with psychotic disorders.

  13 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Cylert (pemoline)." Abbott Pharmaceutical (2001):
  3. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc (2001):
  7. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  8. "Product Information. Prelu-2 (phendimetrazine)." Boehringer-Ingelheim (2001):

  Show all 13 sourcesShow fewer sources

  9. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  10. "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals (2001):
  11. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
  12. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):
  13. "Product Information. Fintepla (fenfluramine)." Zogenix, Inc (2020):