Indication-specific dosing for (dextromethorphan, pseudoephedrine, guaifenesin), frequency-based side effects, comprehensive interactions, contraindications, pregnancy and lactation schedules, and cost information. (2023)

  • amitriptyline

    Amitriptyline potentiates the effects of pseudoephedrine through sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Avoid or use an alternative medication. Tricyclic antidepressants increase or decrease the effects of sympathomimetics by blocking the reuptake of NA or by blocking the uptake of indirect sympathomimetics in the adrenergic neuron.

  • amoxapine

    Amoxapine potentiates the effects of pseudoephedrine through sympathetic (adrenergic) effects, including increased blood pressure and increased heart rate. Avoid or use an alternative medication. Tricyclic antidepressants increase or decrease the effects of sympathomimetics by blocking the reuptake of NA or by blocking the uptake of indirect sympathomimetics in the adrenergic neuron.

  • cabergolín

    Cabergolines, Pseudoephedrine. Mechanism: pharmacodynamic synergism. contraindicated additional vasospasm; risk of high blood pressure.

  • clomipramina

    Clomipramine potentiates the effects of pseudoephedrine through sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Avoid or use an alternative medication. Tricyclic antidepressants increase or decrease the effects of sympathomimetics by blocking the reuptake of NA or by blocking the uptake of indirect sympathomimetics in the adrenergic neuron.

  • cocaine stream

    Topical cocaine increases the effects of pseudoephedrine through sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Avoid or use an alternative medication.

  • desipramin

    Desipramine potentiates the effects of pseudoephedrine through sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Avoid or use an alternative medication. Tricyclic antidepressants increase or decrease the effects of sympathomimetics by blocking the reuptake of NA or by blocking the uptake of indirect sympathomimetics in the adrenergic neuron.

  • desvenlafaxine

    Desvenlafaxine potentiates the effects of pseudoephedrine through sympathetic (adrenergic) effects, including increased blood pressure and increased heart rate. Avoid or use an alternative medication.

  • doxapram

    Doxapram potentiates the effects of pseudoephedrine through pharmacodynamic synergism. Avoid or use an alternative medication. Additive pressor effect.

  • doxepina

    Doxepin potentiates the effects of pseudoephedrine through sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Avoid or use an alternative medication. Tricyclic antidepressants increase or decrease the effects of sympathomimetics by blocking the reuptake of NA or by blocking the uptake of indirect sympathomimetics in the adrenergic neuron.

  • Duloxetine

    Duloxetine potentiates the effects of pseudoephedrine through sympathetic (adrenergic) effects, including increased blood pressure and increased heart rate. Avoid or use an alternative medication.

  • imipramine

    Imipramine potentiates the effects of pseudoephedrine through sympathetic (adrenergic) effects, including increased blood pressure and increased heart rate. Avoid or use an alternative medication. Tricyclic antidepressants increase or decrease the effects of sympathomimetics by blocking the reuptake of NA or by blocking the uptake of indirect sympathomimetics in the adrenergic neuron.

  • Iobenguan I 123

    Pseudoephedrine decreases the effect of iobenguan I 123 through receptor binding competition. Avoid or use an alternative medication. If clinically appropriate, withhold drugs that compete for NE receptor sites for at least 5 half-lives; may lead to false negative imaging results. Do not administer pseudoephedrine for at least 7 days after each dose of iobenguan.

  • Iobenguan I 131

    Pseudoephedrine decreases the effect of iobenguan I 131 through receptor binding competition. Avoid or use an alternative medication. If clinically appropriate, withhold drugs that compete for NE receptor sites for at least 5 half-lives; may lead to false negative imaging results. Do not administer pseudoephedrine for at least 7 days after each dose of iobenguan.

  • isoflurano

    Isoflurane increases the toxicity of pseudoephedrine by mechanism: unknown. Avoid or use an alternative medication. Risk of Vtachycardia, AHT.

  • levomilnacipran

    Levomilnacipran potentiates the effects of pseudoephedrine through sympathetic (adrenergic) effects, including increased blood pressure and increased heart rate. Avoid or use an alternative medication.

  • lofepramina

    lofepramine, pseudoephedrine. Other (see comment). Avoid or use an alternative medication. Comment: Tricyclic antidepressants increase or decrease the effects of sympathomimetics by blocking NE reuptake or by blocking the uptake of indirect sympathomimetics into the adrenergic neuron.

  • take advantage of it

    maprotiline, pseudoephedrine. Other (see comment). Avoid or use an alternative medication. Comment: Tricyclic antidepressants increase or decrease the effects of sympathomimetics by blocking NE reuptake or by blocking the uptake of indirect sympathomimetics into the adrenergic neuron.

  • methoxyflurane

    Methoxyflurane increases the toxicity of pseudoephedrine by mechanism: unknown. Avoid or use an alternative medication. Risk of Vtachycardia, AHT.

  • milnacipran

    Milnacipran potentiates the effects of pseudoephedrine through sympathetic (adrenergic) effects, including increased blood pressure and increased heart rate. Avoid or use an alternative medication.

  • nortriptilina

    Nortriptyline potentiates the effects of pseudoephedrine through sympathetic (adrenergic) effects, including increased blood pressure and increased heart rate. Avoid or use an alternative medication. Tricyclic antidepressants increase or decrease the effects of sympathomimetics by blocking the reuptake of NA or by blocking the uptake of indirect sympathomimetics in the adrenergic neuron.

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  • ozanimod

    Ozanimod increases the toxicity of pseudoephedrine through sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Avoid or use an alternative medication. Because the active metabolite of ozanimod is an inhibitor of MAO-B in vitro, the potential for serious adverse reactions, including hypertensive crisis, exists. Therefore, the concomitant use of ozanimod with medicinal products that may increase norepinephrine or serotonin is not recommended. With simultaneous use, pay attention to high blood pressure.

  • property line

    Protriptyline potentiates the effects of pseudoephedrine through sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Avoid or use an alternative medication. Tricyclic antidepressants increase or decrease the effects of sympathomimetics by blocking the reuptake of NA or by blocking the uptake of indirect sympathomimetics in the adrenergic neuron.

  • Sevofluran

    Sevoflurane increases the toxicity of pseudoephedrine by mechanism: unknown. Avoid or use an alternative medication. Risk of Vtachycardia, AHT.

  • Trazodon

    trazodone, pseudoephedrine. Other (see comment). Avoid or use an alternative medication. Comment: Tricyclic antidepressants increase or decrease the effects of sympathomimetics by blocking NE reuptake or by blocking the uptake of indirect sympathomimetics into the adrenergic neuron.

  • trimipramine

    Trimipramine potentiates the effects of pseudoephedrine through sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Avoid or use an alternative medication. Tricyclic antidepressants increase or decrease the effects of sympathomimetics by blocking the reuptake of NA or by blocking the uptake of indirect sympathomimetics in the adrenergic neuron.

  • venlafaxine

    Venlafaxine potentiates the effects of pseudoephedrine through sympathetic (adrenergic) effects, including increased blood pressure and increased heart rate. Avoid or use an alternative medication.

  • Acetazolamida

    Acetazolamide increases the level or effect of pseudoephedrine through passive renal tubular reabsorption - alkaline urine. Use caution/monitoring.

  • albuterol

    Both albuterol and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • alfuzosina

    Pseudoephedrine decreases the effects of alfuzosin through sympathetic (adrenergic) effects, including increased blood pressure and increased heart rate. Use caution/monitoring.

  • aluminum hydroxide

    Aluminum hydroxide increases the level or effect of pseudoephedrine through passive renal tubular reabsorption - alkaline urine. Use caution/monitoring. Caution with frequent or high-dose antacids

  • ammonium chloride

    Ammonium chloride decreases the effects of pseudoephedrine by an unknown mechanism. Use caution/monitoring. Urinary excretion of indirect-acting alpha/beta agonists (eg, pseudoephedrine) may be increased when co-administered with urinary acidifiers, resulting in lower serum concentrations.

  • Arformoterol

    Both arformoterol and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • Benzfetamina

    Benzphetamine and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • bromocriptine

    bromocriptine, pseudoephedrine. One potentiates the action of the other through pharmacodynamic synergism. Use caution/monitoring. Hypertension, Tac V.

  • chlorpromazine

    chlorpromazine, pseudoephedrine. Mechanism: unknown. Use caution/monitoring. Consider avoiding the use of pseudoephedrine in patients receiving phenothiazines (particularly thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. With concurrent use, watch for signs of ventricular arrhythmias.

  • dexfenfluramina

    Both dexfenfluramine and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increased blood pressure and increased heart rate. Use caution/monitoring.

  • Dexmethylphenidate

    Both dexmethylphenidate and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • dextroanfetamina

    Both dextroamphetamine and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • diethylpropion

    Diethylpropion and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

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  • dobutamine

    Dobutamine and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • dopamine

    Both dopamine and pseudoephedrine increase sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • dopeexamine

    Both dopexamine and pseudoephedrine increase sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • doxazosina

    Pseudoephedrine decreases the effects of doxazosin through sympathetic (adrenergic) effects, including increased blood pressure and increased heart rate. Use caution/monitoring.

  • droxidopa

    Both pseudoephedrine and droxidopa increase sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring. Lying down may increase risk of high blood pressure

  • ephedrine

    Both ephedrine and pseudoephedrine increase sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.ephedrine, pseudoephedrine. Both potentiate the action of the other through pharmacodynamic synergism. Use caution/monitoring.

  • Adrenaline

    Both epinephrine and pseudoephedrine increase sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • inhaled adrenaline

    pseudoephedrine, inhaled epinephrine. One potentiates the effects of the other through sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • Racemic epinephrine

    Both racemic epinephrine and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increased blood pressure and increased heart rate. Use caution/monitoring.

  • Esketamina intranasal

    Intranasal esketamine, pseudoephedrine. One increases the toxicity of the other through sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use caution/monitoring. Blood pressure should be closely monitored when esketamine nasal is used concomitantly with stimulants. .

  • fenfluramina

    Fenfluramine and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • fluphenazine

    fluphenazine, pseudoephedrine. Mechanism: unknown. Use caution/monitoring. Consider avoiding the use of pseudoephedrine in patients receiving phenothiazines (particularly thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. With concurrent use, watch for signs of ventricular arrhythmias.

  • formoterol

    Both formoterol and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • hydralazine

    hydralazine, pseudoephedrine. Mechanism: pharmacodynamic antagonism. Use caution/monitoring. Sympathomimetics may antagonize the activity of some antihypertensive agents.

  • Insulin degludec

    Pseudoephedrine decreases the effect of insulin degludec through pharmacodynamic antagonism. Modify/closely monitor therapy. Sympathomimetics increase blood sugar by stimulating alpha and beta receptors; This effect results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.

  • Insulin degludec/insulin aspart

    Pseudoephedrine decreases the effect of insulin degludec/insulin aspart through pharmacodynamic antagonism. Modify/closely monitor therapy. Sympathomimetics increase blood sugar by stimulating alpha and beta receptors; This effect results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.

  • insulinandetemir

    Pseudoephedrine decreases the effect of insulin detemir through pharmacodynamic antagonism. Modify/closely monitor therapy. Sympathomimetics increase blood sugar by stimulating alpha and beta receptors; This effect results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.

  • insulin glargine

    Pseudoephedrine decreases the effect of insulin glargine through pharmacodynamic antagonism. Modify/closely monitor therapy. Sympathomimetics increase blood sugar by stimulating alpha and beta receptors; This effect results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.

  • inhaled insulin

    Pseudoephedrine decreases the effect of inhaled insulin through pharmacodynamic antagonism. Modify/closely monitor therapy. Sympathomimetics increase blood sugar by stimulating alpha and beta receptors; This effect results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.

  • normal human insulin

    Pseudoephedrine decreases the effect of regular human insulin through pharmacodynamic antagonism. Modify/closely monitor therapy. Sympathomimetics increase blood sugar by stimulating alpha and beta receptors; This effect results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.

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  • isoproterenol

    Both isoproterenol and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • Levalbuterol

    Both levalbuterol and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • lisdexanfetamina

    Lisdexamfetamine and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • metaproterenol

    Both metaproterenol and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • methamphetamine

    Both methamphetamine and pseudoephedrine increase sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • metenamina

    Methenamine decreases the effects of pseudoephedrine by an unknown mechanism. Use caution/monitoring. Urinary excretion of indirect-acting alpha/beta agonists (eg, pseudoephedrine) may be increased when co-administered with urinary acidifiers, resulting in lower serum concentrations.

  • Methyldopa

    Methyldopa potentiates the effects of pseudoephedrine by an unknown mechanism. Use caution/monitoring.

  • Methylenedioxymethamphetamine

    Methylenedioxymethamphetamine and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • rolling

    Midodrine and pseudoephedrine increase sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • nateglinida

    Pseudoephedrine decreases the effect of nateglinide through pharmacodynamic antagonism. Use caution/monitoring. Concomitant use may reduce the hypoglycemic effect of nateglinide.

  • norepinephrine

    Both norepinephrine and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • inhaled olodaterol

    Both inhaled pseudoephedrine and olodaterol increase sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring. Caution with concomitant administration of adrenergic drugs due to additive sympathetic effects

  • oxytocin

    Oxytocin potentiates the effects of pseudoephedrine through pharmacodynamic synergism. Use caution/monitoring.

  • perfected

    perphenazine, pseudoephedrine. Mechanism: unknown. Use caution/monitoring. Consider avoiding the use of pseudoephedrine in patients receiving phenothiazines (particularly thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. With concurrent use, watch for signs of ventricular arrhythmias.

  • fixed

    Both phendimetrazine and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • phentermine

    Both phentermine and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • Fenilefrina

    Phenylephrine and pseudoephedrine increase sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • Fenilefrina VO

    Both oral phenylephrine and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • Pirbuterol

    Both pirbuterol and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • Potassium Phosphate

    Potassium phosphate decreases the effects of pseudoephedrine by an unknown mechanism. Use caution/monitoring. Urinary excretion of indirect-acting alpha/beta agonists (eg, pseudoephedrine) may be increased when co-administered with urinary acidifiers, resulting in lower serum concentrations.

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  • prochlorperazine

    prochlorperazine, pseudoephedrine. Mechanism: unknown. Use caution/monitoring. Consider avoiding the use of pseudoephedrine in patients receiving phenothiazines (particularly thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. With concurrent use, watch for signs of ventricular arrhythmias.

  • promazine

    promazine, pseudoephedrine. Mechanism: unknown. Use caution/monitoring. Risk of cardiac arrhythmias or sudden death, more likely with thioridazine than with other phenothiazines. Interaction more likely in certain predisposed patients. only.

  • promethazine

    promethazine, pseudoephedrine. Mechanism: unknown. Use caution/monitoring. Risk of cardiac arrhythmias or sudden death, more likely with thioridazine than with other phenothiazines. Interaction more likely in certain predisposed patients. only.

  • propilhexedrina

    Both propylhexedrine and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • safinamida

    Both pseudoephedrine and safinamide potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring. Monitor patients for hypertension when safinamide is prescribed in conjunction with prescription or over-the-counter sympathomimetics, including nasal, oral, or ophthalmic decongestants, and cold medications.

  • salmeterol

    Both salmeterol and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • Serdexmethylphenidate/Dexmethylphenidate

    Both serdexmethylphenidate/dexmethylphenidate and pseudoephedrine reduce sedation. Use caution/monitoring.Serdexmethylphenidate/dexmethylphenidate and pseudoephedrine increase sympathetic (adrenergic) effects, including increased blood pressure and increased heart rate. Use caution/monitoring.

  • silodosin

    Pseudoephedrine decreases the effects of silodosin through sympathetic (adrenergic) effects, including increased blood pressure and increased heart rate. Use caution/monitoring.

  • sodium bicarbonate

    Sodium bicarbonate increases the level or effect of pseudoephedrine through passive renal tubular reabsorption - alkaline urine. Use caution/monitoring. Caution with frequent or high-dose antacids

  • sodium citrate/citric acid

    Sodium citrate/citric acid increases the level or effect of pseudoephedrine via passive renal tubular reabsorption - alkaline urine. Use caution/monitoring.

  • sodium lactate

    Sodium lactate increases the level or effect of pseudoephedrine through passive renal tubular reabsorption - alkaline urine. Use caution/monitoring.

  • Sodium phosphate, IV

    Sodium phosphate, IV decreases the effects of pseudoephedrine by an unknown mechanism. Use caution/monitoring. Urinary excretion of indirect-acting alpha/beta agonists (eg, pseudoephedrine) may be increased when co-administered with urinary acidifiers, resulting in lower serum concentrations.

  • solriamfetol

    Both pseudoephedrine and solriamfetol potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • spironolactone

    Spironolactone reduces the effect of pseudoephedrine through pharmacodynamic antagonism. Use caution/monitoring.

  • tamsulosina

    Pseudoephedrine decreases the effects of tamsulosin through sympathetic (adrenergic) effects, including increased blood pressure and increased heart rate. Use caution/monitoring.

  • terazosina

    Pseudoephedrine decreases the effects of terazosin through sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • terbutaline

    Terbutaline and pseudoephedrine potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

  • frozen

    thioridazine, pseudoephedrine. Mechanism: unknown. Use caution/monitoring. Consider avoiding the use of pseudoephedrine in patients receiving phenothiazines (particularly thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. With concurrent use, watch for signs of ventricular arrhythmias.

  • trifluoperazina

    trifluoperazine, pseudoephedrine. Mechanism: unknown. Use caution/monitoring. Consider avoiding the use of pseudoephedrine in patients receiving phenothiazines (particularly thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. With concurrent use, watch for signs of ventricular arrhythmias.

  • xylometazoline

    Pseudoephedrine and xylometazoline potentiate sympathetic (adrenergic) effects, including increases in blood pressure and heart rate. Use caution/monitoring.

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