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Methadone Hydrochloride 10mg Oral tablet

Vicks NyQuil Cold & Flu Relief Liquid (Cherry)

Also checked against the following: Caffeine, Ethanol/Alcohol, Enteral Feedings, Food, Grapefruit juice, Tobacco

Drug interactions found for the following combinations:

Methadone Hydrochloride 10mg Oral tablet and Doxylamine Succinate

Severity: moderate

Concomitant use of opioid agonists with doxylamine may cause excessive sedation and somnolence. Limit the use of opioid pain medication with doxylamine to only patients for whom alternative treatment options are inadequate. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect.

Vicks NyQuil Cold & Flu Relief Liquid (Cherry) and Methadone Hydrochloride

Severity: moderate

Concomitant use of opioid agonists with doxylamine may cause excessive sedation and somnolence. Limit the use of opioid pain medication with doxylamine to only patients for whom alternative treatment options are inadequate. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect.

Methadone Hydrochloride 10mg Oral tablet and Alcohol

Severity: high

Patients who receive methadone should be advised to avoid drinking ethanol (alcohol) or taking prescription or nonprescription medications containing alcohol. Concomitant use of methadone with other central nervous system (CNS) depressants, such as ethanol, can potentiate the effects of methadone and may lead to additive CNS or respiratory depression. This may cause respiratory depression, hypotension, profound sedation, and death. Prior to prescribing methadone, assess the level of tolerance to CNS depression that has developed, the duration of use, and the patient's overall response to treatment. Consider the patient's use of alcohol or illicit drugs. Methadone should be used with caution and in reduced dosages, particularly if the patient is not likely to be compliant with avoiding alcohol. In opioid-naive adults, use an initial methadone dose of 2.5 mg every 12 hours. Monitor patients for sedation and respiratory depression.

Vicks NyQuil Cold & Flu Relief Liquid (Cherry) and Alcohol

Severity: high

The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume ethanol. Patients who drink more than 3 alcoholic drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic ethanol use increases acetaminophen-induced hepatotoxicity by inducing cytochrome P450 CYP 2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume ethanol regularly.

Methadone Hydrochloride 10mg Oral tablet and Grapefruit juice

Severity: moderate

The concurrent administration of methadone and inhibitors of CYP3A4, such as grapefruit juice, may result in increased concentrations of methadone. Inhibition of methadone metabolism can lead to toxicity including CNS adverse effects and potential for QT prolongation and torsades de pointes when high doses of methadone are used.

Vicks NyQuil Cold & Flu Relief Liquid (Cherry) and Alcohol

Severity: moderate

Drowsiness may occur with the use of sedating antihistamines. Caution patients about the simultaneous use of alcohol, and caution that the effects of alcohol may be increased. Additive drowsiness and psychomotor impairment may occur.

Vicks NyQuil Cold & Flu Relief Liquid (Cherry) and Tobacco

Severity: moderate

Tobacco smoking induces the cytochrome P450 isoenzyme CYP1A2 and may potentially increase the risk for acetaminophen-induced hepatotoxicity during overdose via enhanced generation of acetaminophen's hepatotoxic metabolite, NAPQI. In one study, current tobacco smoking was found to be very frequent in patients admitted with acetaminophen poisoning. Tobacco smoking appears to be an independent risk factor of severe hepatotoxicity, acute liver failure and death following acetaminophen overdose.

Vicks NyQuil Cold & Flu Relief Liquid (Cherry) and Grapefruit juice

Severity: low

Intake of grapefruit juice or seville orange juice increased dextromethorphan bioavailability in one study. Patients with increased concentrations of dextromethorphan may experience drowsiness or serotonergic side effects (dizziness, nervousness or restlessness, nausea, vomiting, stomach upset) not usually noted with prescribed or nonprescription product doses. Grapefruit juice and seville orange juice contain compounds that can inhibit P-glycoprotein in the intestinal wall, and dextromethorphan absorption may be affected by P-glycoprotein activity. Dextromethorphan is largely metabolized by CYP2D6, so this particular interaction with grapefruit juice may be more relevant in patients who are poor CYP2D6 metabolizers.

Disclaimer: Do not stop taking your prescription drugs without first talking to your health care professional. This program may not cover all possible drug interactions or all effects that may occur when taking drugs with similar side effects. For example, there is little information available on how herbs interact with drugs. Different individuals may respond to medication in different ways. You should always consult your health care professional if you have questions about the drug(s) you are taking.