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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by JaclinHyde on March 31, 2006, at 14:52:06
I did a medscape check on the interactions of all your meds and this is what came up....
"Patient Regimen
LISINOPRIL ORAL
BENADRYL ORAL
TRAZODONE ORAL
PARNATE ORAL
InteractionsContraindicated Drug Combination
SELECTED SYMPATHOMIMETICS/MAOI'S
Benadryl Oral and Parnate Oral may interact based on the potential interaction between SELECTED SYMPATHOMIMETICS and MAOI'S.Selected Sympathomimetics/MAOI's
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
MONOGRAPH TITLE: Selected Sympathomimetics/MAOI's
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Catecholamine stores increased by MAOIs can be released by indirect acting sympathomimetics such as ephedrine and amphetamine. MAO inhibitors also interfere with gut and liver metabolism of direct acting sympathomimetics (eg oral phenylephrine).
CLINICAL EFFECTS: Potentiation of sympathomimetic effect may be observed. FATALITIES HAVE OCCURED. PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Concurrent use of monoamine oxidase inhibitors and sympathomimetics is contraindicated.
DISCUSSION: Indirect acting sympathomimetic amines may cause abrupt elevation of blood pressure when administered to patients taking monoamine oxidase inhibitors, resulting in a potentially fatal hypertensive crisis.
Mixed (direct and indirect) acting sympathomimetics have also been shown to interact with monoamine oxidase inhibitors depending on their degree of indirect action. The direct-acting sympathomimetics have not been reported to interact. Dopamine is metabolized by monoamine oxidase, and its pressor effect is enhanced by monoamine oxidase inhibitors.
Since procarbazine, an antineoplastic agent, is a weak monoamine oxidase inhibitor, hypertensive reactions may result from its concurrent use with indirect and mixed acting sympathomimetics.
Furazolidone, an antibacterial with monoamine oxidase inhibitor action, has also been shown to interact with indirect acting sympathomimetics.
Linezolid is another antibacterial with monoamine oxidase inhibitor properties.
Foods containing large amounts of tyramine have also been implicated in this interaction.
REFERENCES:
1.Goldberg LI. Monoamine oxidase inhibitors. Adverse reactions and possible mechanisms. JAMA 1964 Nov 2;190(5):456-62.
2.Pettinger WA, Soyangco FG, Oates JA. Inhibition of monoamine oxidase in man by furazolidone. Clin Pharmacol Ther 1968 Jul-Aug;9(4):442-7.
3.Nardil (phenelzine sulfate) US prescribing information. Parke-Davis January, 2005.
4.Adderall (amphetamine) US prescribing information. Shire US Inc. June, 2005.
5.Marplan (isocarboxazid) US prescribing information. Oxford Pharmaceutical Services, Inc. January, 2002.
6.Ritalin (methylphenidate hydrochloride) US prescribing information. Novartis January, 2001.
7.Focalin XR (dexmethylphenidate hydrochloride) US prescribing information. Novartis Pharmaceuticals Corporation May, 2005."
Can you say "I'd rather sneeze than die"? I did a check on Claritin and Zyrtec and both were fine with everything you are taking. Sp PLEASE switch to one of this for your allergies and cut out the big "B". I'd miss you buddy.
This one is on me, no payment required ;-)
Parnate Protector
Terri/JH
Posted by ed_uk on March 31, 2006, at 15:59:05
In reply to TYLER PLEASE READ!!, posted by JaclinHyde on March 31, 2006, at 14:52:06
Hi
>Benadryl Oral and Parnate Oral may interact based on the potential interaction between SELECTED SYMPATHOMIMETICS and MAOI'S.
Diphenhydramine (Benadryl) is not a sympathomimetic, it is an antihistamine.
Ed
Posted by ed_uk on March 31, 2006, at 16:17:00
In reply to Re: TYLER PLEASE READ!! » JaclinHyde, posted by ed_uk on March 31, 2006, at 15:59:05
Hi
Tyler is taking diphenhydramine. Diphenhydramine is not a sympathomimetic. BENADRYL is used as a brand name for *many* OTC products, some of which contain decongestants. Decongestants are sympathomimetics which can induce hypertension when administered to a patient who is taking an MAOI.
AFAIK, Tyler is just taking plain diphenhydramine, nothing else.
Be very careful with OTC products. Be sure to read all the ingredients on every pack. BE AWARE that the same brand name is used for many different products, with DIFFERENT active ingredients - some of which will interact, and some of which will not.
Ed
Posted by TylerJ on March 31, 2006, at 16:58:30
In reply to TYLER PLEASE READ!!, posted by JaclinHyde on March 31, 2006, at 14:52:06
> I did a medscape check on the interactions of all your meds and this is what came up....
>
> "Patient Regimen
>
> LISINOPRIL ORAL
> BENADRYL ORAL
> TRAZODONE ORAL
> PARNATE ORAL
>
>
> Interactions
>
> Contraindicated Drug Combination
> SELECTED SYMPATHOMIMETICS/MAOI'S
> Benadryl Oral and Parnate Oral may interact based on the potential interaction between SELECTED SYMPATHOMIMETICS and MAOI'S.
>
> Selected Sympathomimetics/MAOI's
>
> This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
>
> MONOGRAPH TITLE: Selected Sympathomimetics/MAOI's
>
> SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
>
> MECHANISM OF ACTION: Catecholamine stores increased by MAOIs can be released by indirect acting sympathomimetics such as ephedrine and amphetamine. MAO inhibitors also interfere with gut and liver metabolism of direct acting sympathomimetics (eg oral phenylephrine).
>
> CLINICAL EFFECTS: Potentiation of sympathomimetic effect may be observed. FATALITIES HAVE OCCURED. PREDISPOSING FACTORS: None determined.
>
> PATIENT MANAGEMENT: Concurrent use of monoamine oxidase inhibitors and sympathomimetics is contraindicated.
>
> DISCUSSION: Indirect acting sympathomimetic amines may cause abrupt elevation of blood pressure when administered to patients taking monoamine oxidase inhibitors, resulting in a potentially fatal hypertensive crisis.
>
> Mixed (direct and indirect) acting sympathomimetics have also been shown to interact with monoamine oxidase inhibitors depending on their degree of indirect action. The direct-acting sympathomimetics have not been reported to interact. Dopamine is metabolized by monoamine oxidase, and its pressor effect is enhanced by monoamine oxidase inhibitors.
>
> Since procarbazine, an antineoplastic agent, is a weak monoamine oxidase inhibitor, hypertensive reactions may result from its concurrent use with indirect and mixed acting sympathomimetics.
>
> Furazolidone, an antibacterial with monoamine oxidase inhibitor action, has also been shown to interact with indirect acting sympathomimetics.
>
> Linezolid is another antibacterial with monoamine oxidase inhibitor properties.
>
> Foods containing large amounts of tyramine have also been implicated in this interaction.
>
> REFERENCES:
>
> 1.Goldberg LI. Monoamine oxidase inhibitors. Adverse reactions and possible mechanisms. JAMA 1964 Nov 2;190(5):456-62.
>
> 2.Pettinger WA, Soyangco FG, Oates JA. Inhibition of monoamine oxidase in man by furazolidone. Clin Pharmacol Ther 1968 Jul-Aug;9(4):442-7.
>
> 3.Nardil (phenelzine sulfate) US prescribing information. Parke-Davis January, 2005.
>
> 4.Adderall (amphetamine) US prescribing information. Shire US Inc. June, 2005.
>
> 5.Marplan (isocarboxazid) US prescribing information. Oxford Pharmaceutical Services, Inc. January, 2002.
>
> 6.Ritalin (methylphenidate hydrochloride) US prescribing information. Novartis January, 2001.
>
> 7.Focalin XR (dexmethylphenidate hydrochloride) US prescribing information. Novartis Pharmaceuticals Corporation May, 2005."
>
> Can you say "I'd rather sneeze than die"? I did a check on Claritin and Zyrtec and both were fine with everything you are taking. Sp PLEASE switch to one of this for your allergies and cut out the big "B". I'd miss you buddy.
>
> This one is on me, no payment required ;-)
>
> Parnate Protector
> Terri/JHThanks Terri...you're the best. I didn't take Benadryl last night and definitely won't take it again! Even my Pdoc said it would be okay...can you believe that? Still tired today, it's frustrating because I feel so good, but too tired to enjoy it. What do you think of taking 80 mgs. parnate in the morning, and 40 mgs at noon?
Your Parnate Pal (who was almost your Late Parnate Pal) Whew!
Tyler
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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