Pseudoephedrine + Guaiphenasine + Triprolidine interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

  What to do: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

  4 sources

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
  3. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  4. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):

Conditions

Conditions in which Pseudoephedrine + Guaiphenasine + Triprolidine needs care, as documented in this source.

• Cardiovascular Diseases

  Major

  Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

  58 sources

  1. Humberstone PM "Hypertension from cold remedies." Br Med J 1 (1969): 846
  2. Mariani PJ "Pseudoephedrine-induced hypertensive emergency: treatment with labetalol." Am J Emerg Med 4 (1986): 141-2
  3. Rosen RA "Angina associated with pseudoephedrine ." Ann Emerg Med 10 (1981): 230-1
  4. Wiener I, Tilkian AG, Palazzolo M "Coronary artery spasm and myocardial infarction in a patient with normal coronary arteries: temporal relationship to pseudoephedrine ingestion." Cathet Cardiovasc Diagn 20 (1990): 51-3
  5. Gordon RD, Ballantine DM, Bachmann AW "Effects of repeated doses of pseudoephedrine on blood pressure and plasma catecholamines in normal subjects and in patients with phaeochromocytoma." Clin Exp Pharmacol Physiol 19 (1992): 287-90
  6. Loizou LA, Hamilton JG, Tsementzis SA "Intracranial haemorrhage in association with pseudoephedrine overdose." J Neurol Neurosurg Psychiatry 45 (1982): 471-2
  7. Dickerson J, Perrier D, Mayersohn M, Bressler R "Dose tolerance and pharmacokinetic studies of L (+) pseudoephedrine capsules in man." Eur J Clin Pharmacol 14 (1978): 253-9
  8. Wooten MR, Khangure MS, Murphy MJ "Intracerebral hemorrhage and vasculitis related to ephedrine abuse." Ann Neurol 13 (1983): 337-40

  Show all 58 sourcesShow fewer sources

  9. To LB, Sangster JF, Rampling D, Cammens I "Ephedrine-induced cardiomyopathy." Med J Aust 2 (1980): 35-6
  10. Bruno A, Nolte KB, Chapin J "Stroke associated with ephedrine use." Neurology 43 (1993): 1313-6
  11. Stoessl AJ, Young GB, Feasby TE "Intracerebral haemorrhage and angiographic beading following ingestion of catecholaminergics." Stroke 16 (1985): 734-6
  12. Covington TR, eds., Lawson LC, Young LL "Handbook of Nonprescription Drugs." Washington, DC: American Pharmaceutical Association (1993):
  13. "Product Information. Sudafed (pseudoephedrine)." Glaxo Wellcome (2001):
  14. Kizer KW "Intracranial hemorrhage associated with overdose of decongestant containing phenylpropanolamine" Am J Emerg Med 2 (1984): 180-1
  15. Edwards M, Russo L, Harwood-Nuss A "Cerebral infarction with a single oral dose of phenylpropanolamine." Am J Emerg Med 5 (1987): 163-4
  16. Lake CR, Gallant S, Masson E, Miller P "Adverse drug effects attributed to phenylpropanolamine: a review of 142 case reports." Am J Med 89 (1990): 195-208
  17. Lake CR, Zaloga G, Bray J, Rosenberg D, Chernow B "Transient hypertension after two phenylpropanolamine diet aids and the effects of caffeine: a placebo-controlled follow-up study." Am J Med 86 (1989): 427-32
  18. Lake CR, Zaloga G, Clymer R, Quirk RM, Chernow B "A double dose of phenylpropanolamine causes transient hypertension." Am J Med 85 (1988): 339-43
  19. Bernstein E, Diskant BM "Phenylpropanolamine: a potentially hazardous drug." Ann Emerg Med 11 (1982): 311-5
  20. Kroenke K, Omori DM, Simmons JO, Wood DR, Meier NJ "The safety of phenylpropanolamine in patients with stable hypertension." Ann Intern Med 111 (1989): 1043-4
  21. Pentel PR, Mikell FL, Zavoral JH "Myocardial injury after phenylpropanolamine ingestion." Br Heart J 47 (1982): 51-4
  22. Howrie DL, Wolfson JH "Phenylpropanolamine-induced hypertensive seizures." J Pediatr 102 (1983): 143-5
  23. Horowitz JD, Lang WJ, Howes LG, Fennessy MR, Christophidis N, Rand MJ, Louis WJ "Hypertensive responses induced by phenylpropanolamine in anorectic and decongestant preparations." Lancet 1 (1980): 60-1
  24. Johnson DA, Etter HS, Reeves DM "Stroke and phenylpropanolamine use" Lancet 2 (1983): 970
  25. McEwen J "Phenylpropanolamine-associated hypertension after the use of "over- the-counter" appetite-suppressant products." Med J Aust 2 (1983): 71-3
  26. Elliott CF, Whyte JC "Phenylpropanolamine and hypertension." Med J Aust 1 (1981): 715
  27. Maher LM, Peterson PL, Dela-Cruz C "Postpartum intracranial hemorrhage and phenylpropanolamine use" Neurology 37 (1987): 1686
  28. Kase CS, Foster TE, Reed JE, Spatz EL, Girgis GN "Intracerebral hemorrhage and phenylpropanolamine use." Neurology 37 (1987): 399-404
  29. Kikta DG, Devereaux MW, Chandar K "Intracranial hemorrhages due to phenylpropanolamine." Stroke 16 (1985): 510-2
  30. Clark JE, Simon WA "Cardiac arrhythmias after phenylpropanolamine ingestion." Drug Intell Clin Pharm 17 (1983): 737-8
  31. Noble R "A controlled clinical trial of the cardiovascular and psychological effects of phenylpropanolamine and caffeine." Drug Intell Clin Pharm 22 (1988): 296-9
  32. O'Connell MB, Gross CR "The effect of multiple doses of phenylpropanolamine on the blood pressure of patients whose hypertension was controlled with beta blockers." Pharmacotherapy 11 (1991): 376-81
  33. O'Connell MB, Gross CR "The effect of single-dose phenylpropanolamine on blood pressure in patients with hypertension controlled by beta blockers." Pharmacotherapy 10 (1990): 85-91
  34. Chin C, Choy M "Cardiomyopathy induced by phenylpropanolamine." J Pediatr 123 (1993): 825-7
  35. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  36. Lee KY, Beilin LJ, Vandongen R "Severe hypertension after ingestion of an appetite suppressant (phenylpropanolamine) with indomethacin." Lancet 1 (1979): 1110-1
  37. Gibson GJ, Warrell DA "Hypertensive crises and phenylpropanolamine." Lancet 2 (1972): 492-3
  38. Frewin DB "Phenylpropanolamine. How safe is it?" Med J Aust 2 (1983): 54-5
  39. Lee KY, Beilin LJ, Vandongen R "Severe hypertension after administration of phenylpropanolamine" Med J Aust 1 (1979): 525-6
  40. Horowitz JD, McNeil JJ, Sweet B, Mendelsohn FA, Louis WJ "Hypertension and postural hypotension induced by phenylpropanolamine (Trimolets)." Med J Aust 1 (1979): 175-6
  41. Frewin DB, Leonello PP, Frewin ME "Hypertension after ingestion of Trimolets." Med J Aust 2 (1978): 497-8
  42. Teh AY "Phenylpropanolamine and hypertension" Med J Aust 2 (1979): 425-6
  43. Shapiro SR "Hypertension due to anorectic agent." N Engl J Med 280 (1969): 1363
  44. Maher LM, Peterson PL, Dela-Cruz C "Postpartum intracranial hemorrhage and phenylpropanolamine use." Neurology 37 (1987): 1886,1890
  45. Fallis RJ, Fisher M "Cerebral vasculitis and hemorrhage associated with phenylpropanolamine." Neurology 35 (1985): 405-7
  46. Caperton E "Raynaud's phenomenon. Role of diet pills and cold remedies." Postgrad Med 73 (1983): 291-2
  47. McDowell JR, LeBlanc HJ "Phenylpropanolamine and cerebral hemorrhage." West J Med 142 (1985): 688-91
  48. Williams DM "Phenylpropanolamine hydrochloride" Am Pharm NS30 (1990): 47-50
  49. Dowse R, Scherzinger SS, Kanfer I "Serum concentrations of phenylpropanolamine and associated effects on blood pressure in normotensive subjects: a pilot-study." Int J Clin Pharmacol Ther Toxicol 28 (1990): 205-10
  50. Pentel PR, Aaron C, Paya C "Therapeutic doses of phenylpropanolamine increase supine systolic blood pressure." Int J Obes 9 (1985): 115-9
  51. Finton CK, Barton M, Chernow B "Possible adverse effects of phenylpropanolamine (diet pills) on sympathetic nervous system function--caveat emptor!" Mil Med 147 (1982): 1072
  52. "Product Information. Adrenalin (EPINEPHrine)." Apothecon Inc (2022):
  53. Leo PJ, Hollander JE, Shih RD, Marcus SM "Phenylpropanolamine and associated myocardial injury." Ann Emerg Med 28 (1996): 359-62
  54. Gill ND, Shield A, Blazevich AJ, Zhou S, Weatherby RP "Muscular and cardiorespiratory effects of pseudoephedrine in human athletes." Br J Clin Pharmacol 50 (2000): 205-13
  55. Haller CA, Benowitz NL "Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids." N Engl J Med 343 (2000): 1833-8
  56. Mansoor GA "Herbs and alternative therapies in the hypertension clinic." Am J Hypertens 14(9 Pt 1) (2001): 971-5
  57. Samenuk D, Link MS, Homoud MK, et al. "Adverse cardiovascular events temporally associated with ma huang, an herbal source of ephedrine." Mayo Clin Proc 77 (2002): 12-6
  58. "Product Information. Akovaz (ephedrine)." Eclat Pharmaceuticals (2016):

• Anticholinergic Syndrome

  Moderate

  Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.

  20 sources

  1. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86
  2. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories (2002):
  3. "Product Information. Chlor-Trimeton (chlorpheniramine)." Schering-Plough
  4. "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc (2002):
  5. "Product Information. Benadryl (diphenhydramine)." Parke-Davis (2002):
  6. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories (2001):
  7. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation (2001):
  8. "Product Information. Antivert (meclizine)." Roerig Division (2001):

  Show all 20 sourcesShow fewer sources

  9. "Product Information. Marezine (cyclizine)." Glaxo Wellcome (2001):
  10. "Product Information. Optimine (azatadine)." Schering Corporation (2001):
  11. "Product Information. Semprex-D (acrivastine-pseudoephedrine)." Endo Laboratories LLC (2001):
  12. "Product Information. Zyrtec (cetirizine)." Pfizer U.S. Pharmaceuticals (2001):
  13. "Product Information. Drixoral (dextromethorphan)." Schering-Plough (2001):
  14. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company (2001):
  15. Watemberg NM, Roth KS, Alehan FK, Epstein CE "Central anticholinergic syndrome on therapeutic doses of cyproheptadine." Pediatrics 103 (1999): 158-60
  16. "Product Information. Vistaril (hydroxyzine)." Pfizer U.S. Pharmaceuticals (2001):
  17. "Product Information. Dramamine (dimenhydrinate)." Pharmacia and Upjohn (2001):
  18. "Product Information. Tacaryl (methdilazine)." Westwood Squibb Pharmaceutical Corporation (2001):
  19. "Product Information. Temaril (trimeprazine)." Allergan Inc (2001):
  20. Talbert RL, Yee GC, DiPiro JT, Matzke GR, Posey LM, Wells BG "Pharmacotherapy: A Pathophysiologic Approach" Stamford, CT: Appleton & Lange (1999):

• Asthma

  Moderate

  It has been suggested that the anticholinergic effect of antihistamines may reduce the volume and cause thickening of bronchial secretions, resulting in obstruction of respiratory tract. Some manufacturers and clinicians recommend that therapy with antihistamines be administered cautiously in patients with asthma or chronic obstructive pulmonary disease.

  17 sources

  1. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories (2002):
  2. "Product Information. Chlor-Trimeton (chlorpheniramine)." Schering-Plough
  3. "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc (2002):
  4. "Product Information. Benadryl (diphenhydramine)." Parke-Davis (2002):
  5. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories (2001):
  6. Maddox DE, Reed CE "Clinical pharmacodynamics of antihistamines." Ann Allergy 59 (1987): 43-8
  7. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation (2001):
  8. "Product Information. Antivert (meclizine)." Roerig Division (2001):

  Show all 17 sourcesShow fewer sources

  9. "Product Information. Marezine (cyclizine)." Glaxo Wellcome (2001):
  10. "Product Information. Optimine (azatadine)." Schering Corporation (2001):
  11. "Product Information. Semprex-D (acrivastine-pseudoephedrine)." Endo Laboratories LLC (2001):
  12. "Product Information. Drixoral (dextromethorphan)." Schering-Plough (2001):
  13. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company (2001):
  14. "Product Information. Vistaril (hydroxyzine)." Pfizer U.S. Pharmaceuticals (2001):
  15. "Product Information. Dramamine (dimenhydrinate)." Pharmacia and Upjohn (2001):
  16. "Product Information. Tacaryl (methdilazine)." Westwood Squibb Pharmaceutical Corporation (2001):
  17. "Product Information. Temaril (trimeprazine)." Allergan Inc (2001):

• Cardiovascular Diseases

  Moderate

  Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.

  15 sources

  1. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86
  2. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories (2002):
  3. "Product Information. Chlor-Trimeton (chlorpheniramine)." Schering-Plough
  4. "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc (2002):
  5. "Product Information. Benadryl (diphenhydramine)." Parke-Davis (2002):
  6. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation (2001):
  7. "Product Information. Antivert (meclizine)." Roerig Division (2001):
  8. "Product Information. Optimine (azatadine)." Schering Corporation (2001):

  Show all 15 sourcesShow fewer sources

  9. Smith SJ "Cardiovascular toxicity of antihistamines." Otolaryngol Head Neck Surg 111 Suppl (1994): 348-54
  10. "Product Information. Zyrtec (cetirizine)." Pfizer U.S. Pharmaceuticals (2001):
  11. Woosley RL "Cardiac actions of antihistamines." Annu Rev Pharmacol Toxicol 36 (1996): 233-52
  12. "Product Information. Drixoral (dextromethorphan)." Schering-Plough (2001):
  13. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company (2001):
  14. "Product Information. Vistaril (hydroxyzine)." Pfizer U.S. Pharmaceuticals (2001):
  15. "Product Information. Dramamine (dimenhydrinate)." Pharmacia and Upjohn (2001):

• Diabetes Mellitus

  Moderate

  Sympathomimetic agents may cause increases in blood glucose concentrations. These effects are usually transient and slight but may be significant with dosages higher than those normally recommended. Therapy with sympathomimetic agents should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate.

  6 sources

  1. Covington TR, eds., Lawson LC, Young LL "Handbook of Nonprescription Drugs." Washington, DC: American Pharmaceutical Association (1993):
  2. "Product Information. Sudafed (pseudoephedrine)." Glaxo Wellcome (2001):
  3. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  4. Williams DM "Phenylpropanolamine hydrochloride" Am Pharm NS30 (1990): 47-50
  5. "Product Information. Adrenalin (EPINEPHrine)." Apothecon Inc (2022):
  6. "Product Information. Akovaz (ephedrine)." Eclat Pharmaceuticals (2016):

• Glaucoma

  Moderate

  Sympathomimetic agents can induce transient mydriasis via stimulation of alpha-1 adrenergic receptors. In patients with anatomically narrow angles or narrow-angle glaucoma, pupillary dilation can provoke an acute attack. In patients with other forms of glaucoma, mydriasis may occasionally increase intraocular pressure. Therapy with sympathomimetic agents should be administered cautiously in patients with or predisposed to glaucoma, particularly narrow-angle glaucoma.

  3 sources

  1. Covington TR, eds., Lawson LC, Young LL "Handbook of Nonprescription Drugs." Washington, DC: American Pharmaceutical Association (1993):
  2. "Product Information. Sudafed (pseudoephedrine)." Glaxo Wellcome (2001):
  3. Fraunfelder FT, Fraunfelder FW; Randall JA "Drug-Induced Ocular Side Effects" Boston, MA: Butterworth-Heinemann (2001):

• Intestinal Obstruction

  Moderate

  The extended-release formulation of pseudoephedrine (Sudafed 24 Hour) contains a non-deformable material. There have been rare reports of obstructive symptoms in patients with known strictures following the ingestion of similar sustained-release products. Therapy with the extended-release formulation of pseudoephedrine should be administered cautiously in patients with preexisting severe gastrointestinal narrowing or obstruction, whether pathologic or iatrogenic.

  1 source

  1. "Product Information. Sudafed (pseudoephedrine)." Glaxo Wellcome (2001):

• Liver Diseases

  Moderate

  Limited pharmacokinetic data are available for the older, first-generation antihistamines. Many appear to be primarily metabolized by the liver, and both parent drugs and metabolites are excreted in the urine. Patients with renal and/or liver disease may be at greater risk for adverse effects from antihistamines due to drug and metabolite accumulation. Therapy with antihistamines should be administered cautiously in such patients. Lower initial dosages may be appropriate.

  15 sources

  1. Glazko AJ, Dill WA, Young RM, Smith TC, Ogilvie RI "Metabolic disposition of diphenhydramine." Clin Pharmacol Ther 16 (1974): 1066-76
  2. Paton DM, Webster DR "Clinical pharmacokinetics of H1-receptor antagonists (the antihistamines)." Clin Pharmacokinet 10 (1985): 477-97
  3. Rumore MM "Clinical pharmacokinetics of chlorpheniramine." Drug Intell Clin Pharm 18 (1984): 701-7
  4. Huang SM, Athanikar NK, Sridhar K, Huang YC, Chiou WL "Pharmacokinetics of chlorpheniramine after intravenous and oral administration in normal adults." Eur J Clin Pharmacol 22 (1982): 359-65
  5. Simons KJ, Simons FE, Luciuk GH, Frith EM "Urinary excretion of chlorpheniramine and its metabolites in children." J Pharm Sci 73 (1984): 595-9
  6. Meredith CG, Christian CD Jr, Johnson RF, Madhavan SV, Schenker S "Diphenhydramine disposition in chronic liver disease." Clin Pharmacol Ther 35 (1984): 474-9
  7. Blyden GT, Greenblatt DJ, Scavone JM, Shader RI "Pharmacokinetics of diphenhydramine and a demethylated metabolite following intravenous and oral administration." J Clin Pharmacol 26 (1986): 529-33
  8. Albert KS, Hallmark MR, Sakmar E, Weidler DJ, Wagner JG "Pharmacokinetics of diphenhydramine in man." J Pharmacokinet Biopharm 3 (1975): 159-70

  Show all 15 sourcesShow fewer sources

  9. Simons FE, Frith EM, Simons KJ "The pharmacokinetics and antihistaminic effects of brompheniramine." J Allergy Clin Immunol 70 (1982): 458-64
  10. Bruce RB, Turnbull LB, Newman JH, Pitts JE "Metabolism of brompheniramine." J Med Chem 11 (1968): 1031-4
  11. Porter CC, Arison BH, Gruber VF, Titus DC, Vandenheuvel WJ "Human metabolism of cyproheptadine." Drug Metab Dispos 3 (1975): 189-97
  12. Hintze KL, Wold JS, Fischer LJ "Disposition of cyproheptadine in rats, mice, and humans and identification of a stable epoxide metabolite." Drug Metab Dispos 3 (1975): 1-9
  13. Maddox DE, Reed CE "Clinical pharmacodynamics of antihistamines." Ann Allergy 59 (1987): 43-8
  14. Simons FE, Simons KJ, Frith EM "The pharmacokinetics and antihistaminic of the H1 receptor antagonist hydroxyzine." J Allergy Clin Immunol 73 (1984): 69-75
  15. Simons FE, Watson WT, Chen XY, Minuk GY, Simons KJ "The pharmacokinetics and pharmacodynamics of hydroxyzine in patients with primary biliary cirrhosis." J Clin Pharmacol 29 (1989): 809-15

• Phenylketonurias

  Moderate

  Chewable products frequently may contain aspartame, which is metabolized in the gastrointestinal tract to phenylalanine. Sudafed (brand of pseudoephedrine) chewable 15 mg tablets provide the equivalent of 0.78 mg of phenylalanine per each tablet. The aspartame/phenylalanine content should be considered when this and similar products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

  1 source

  1. "Product Information. Sudafed (pseudoephedrine)." Glaxo Wellcome (2001):

• Prostatic Hyperplasia

  Moderate

  Sympathomimetic agents may cause or worsen urinary difficulty in patients with prostate enlargement due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate.

  4 sources

  1. Covington TR, eds., Lawson LC, Young LL "Handbook of Nonprescription Drugs." Washington, DC: American Pharmaceutical Association (1993):
  2. "Product Information. Sudafed (pseudoephedrine)." Glaxo Wellcome (2001):
  3. Williams DM "Phenylpropanolamine hydrochloride" Am Pharm NS30 (1990): 47-50
  4. "Product Information. Akovaz (ephedrine)." Eclat Pharmaceuticals (2016):

Therapeutic duplication

Drug classes that overlap with Pseudoephedrine + Guaiphenasine + Triprolidine, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Chlorpheniramine/ibuprofen/phenylephrine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Pro-chlo

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): All day allergy-d

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Promethazine dm

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Lodrane d

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Phenylephrine/promethazine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Notuss-forte

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Sutan-dm

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Norel sr

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Dexbrompheniramine/phenylephrine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Dallergy

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Resperal-dm

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Coldcough syrup

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Diphenhydramine/naproxen

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Bromhist-pdx

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Chlorpheniramine/methscopolamine/phenylephrine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Nasopen

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Supress a pediatric

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Rescon

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Dextromethorphan/diphenhydramine/phenylephrine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Theraflu nighttime severe cold & cough

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Robitussin peak cold nighttime nasal relief

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Phenylephrine/pyrilamine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Chlorpheniramine/ibuprofen/pseudoephedrine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Chlorpheniramine/pseudoephedrine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Doxylamine/pyridoxine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Pheniramine/phenylephrine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Sympak ii

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Dextromethorphan/pyrilamine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Premsyn pms

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Acetaminophen/chlorpheniramine/dextromethorphan/pseudoephedrine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Nohist dm

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Drixoral cold and allergy

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Meperidine/promethazine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Tannic-12 s

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Coricidin hbp cold & flu

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Poly-tussin ac

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Brompheniramine/dextromethorphan/phenylephrine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): First mouthwash blm

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Theraflu sinus & cold

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Nohist-a

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Diabetic tussin night time formula

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Percogesic original strength

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Diphenhydramine/ibuprofen

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Tuzistra xr

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Triaminic

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Diphenhydramine/phenylephrine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Vicks nyquil cold & flu nighttime relief

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Hyoscyamine/phenyltoloxamine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Codeine/promethazine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): M-end dmx

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Tussionex pennkinetic

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Aspirin/chlorpheniramine/dextromethorphan/phenylpropanolamine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Semprex-d

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Dologesic df

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Doans pm

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Rymed

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Robitussin children's cough & cold long-acting

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Chlorpheniramine/dextromethorphan/pseudoephedrine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Promethazine vc with codeine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Vicks nyquil severe cold & flu

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Vicks nyquil cough

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Betatan

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Sinarest

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Vanacof

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Aspirin/chlorpheniramine/phenylephrine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Poly hist forte

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Rynex pe

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Chlorpheniramine/phenylephrine

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Vicks nyquil d cold and flu nighttime relief

• antihistamines

  The recommended maximum number of medicines in the 'antihistamines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antihistamines' category.

  Example product in the source data (US market): Flextra

• decongestants

  The recommended maximum number of medicines in the 'decongestants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'decongestants' category.

  Example product in the source data (US market): Triaminic

• decongestants

  The recommended maximum number of medicines in the 'decongestants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'decongestants' category.

  Example product in the source data (US market): Guaifenex

• decongestants

  The recommended maximum number of medicines in the 'decongestants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'decongestants' category.

  Example product in the source data (US market): Aspirin/chlorpheniramine/dextromethorphan/phenylpropanolamine

• decongestants

  The recommended maximum number of medicines in the 'decongestants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'decongestants' category.

  Example product in the source data (US market): Hycomine