Phenytoin Chlorpromazine

Drugs that meet one or more of the criteria given above and have been shown to exhibit significant differences in the bioavailability of marketed dosage forms include digoxin, quinidine, furosemide, nitrofurantoin, prednisone, chloramphenicol, theophylline, chlorpromazine, phenytoin, amitriptyline, and phenylbutazone. 

Increasing the gastric pH, which causes a decrease in absorption of weakly acidic drugs and results in a decreased drug effect (eg, digoxin, phenytoin, chlorpromazine, and isoniazid)... 

The following drugp have a decreased pharmacologic effect when administered with an antacid corticosteroids, digoxin, chlorpromazine, oral iron products, isoniazid, phenothiazines, ranitidine, phenytoin, valproic acid, and the tetracyclines. 

Atenolol, hydralazine, procainamide, quinidine, carbamazepine, chlorpromazine, ethosuximide, isoniazid, methyldopa, minocycline, penicillamine, phenylbutazone, phenytoin, thiazides, and valproic acid... 

Acetazolamide, allopurinol, aspirin, captopril, carbamazepine, chloramphenicol, chlorpromazine, dapsone, felbamate, gold salts, metronidazole, methimazole, penicillamine, pentoxifylline, phenothiazines, phenytoin, propylthiouracil, quinidine, sulfonamide antimicrobials, sulfonylureas, and ticlopidine... 

Amiodarone, bleomycin, captopril, chlorpropamide, chlorpromazine, imipramine, methotrexate, and phenytoin... 

Drugs that may affect valproic acid include carbamazepine, charcoal, chlorpromazine, cholestyramine, cimetidine, erythromycin, ethosuximide, felbamate, lamotrigine, phenytoin, rifampin, and salicylates. Drugs that may be affected by valproic acid include carbamazepine, clonazepam, diazepam, ethosuximide, lamotrigine, phenobarbital, phenytoin, tolbutamide, tricyclic antidepressants, warfarin, and zidovudine. 

Admixture Incompatibilities Physical incompatibilities resulted when linezolid IV injection was combined with the following drugs during simulated Y-site administration amphotericin B, chlorpromazine hydrochloride, diazepam, pentamidine isothionate, erythromycin lactobionate, phenytoin sodium, and trimethoprim-sulfamethoxazole. Additionally, chemical incompatibility resulted when linezolid IV injection was combined with ceftriaxone sodium. 

Phenobarbital and other barbiturates1 Barbiturates, chloramphenicol, chlorpromazine, cortisol, coumarin anticoagulants, desmethylimipramine, digitoxin, doxorubicin, estradiol, phenylbutazone, phenytoin, quinine, testosterone... 

Morphine Sulfate Morphine sulfate precipitates in alkaline media and drugs that are incompatible with it, including aminophylline, sodium salts of barbiturates, and phenytoin. Precipitate was found after 2 horns when morphine sulfate was formulated with acyclovir sodium.70 Incompatibilities also are reported with chlorpromazine hydrochloride injections containing chlorocresol. Admixture of morphine sulfate (1 mg/mL), doxorubicin in doxorubicin hydrochloride... 

Verbeeck RK, Cardinal J (1985) Plasma protein binding of salicylic acid, phenytoin, chlorpromazine, propranolol and pethidine using equilibrium dialysis and ultracentrifugation. Arzneimittelforschung 35 903... 

Chlorpromazine, and in some cases other phenothiazines, has been reported to increase plasma phenytoin concentrations (656-659), to reduce plasma phenytoin concentrations (657-661), or to have no effect (658). In one case co-administration of thioridazine caused phenytoin toxicity (662). 

Hepatitis with cholestasis Chlorpromazine, tricyclics, erythromycin, flucloxacillin, co-amoxiclav, ACE inhibitors, phenytoin, NSAIDs, ranitidine, propafenone, ketoconazole, azathioprine, gold salts, penicillamine... 

Inducers of UGT include carbamazepine, phenobarbital, phenytoin and rifampin. Inhibitors of UGTs include amitriptyline, chlorpromazine, ciclosporin, clomipramine, diazepam, lorazepam, nitrazepam and valproic acid,... 

Drugs that bind strongly to red blood cells may exhibit concentration-dependent uptake from plasma. This is reported for acetazolamide, chlorthali-done, and cyclosporine. " The determination of the blood to plasma (B/P) ratios can be method specific. For example, the determination of the B/P ratio of cyclosporine A increases from 1.5-3.0 when estimated at body temperature (37°C) compared with a ratio of 2.5-10.0 at room temperature (20°C). Drugs reported to bind strongly to the erythrocytes (B/P ratio > 1) are promazine, chlorpromazine, propranolol, salicylate, phenobarbital, pentazocine, and phenytoin. " ... 

Chlorpromazine Phenobarbital Phenytoin Valproate Probably of little clinical relevance for phenytoin, a fall in concentration has also been reported Inhibition of metabolism of the object drugs... 

Clinically important, potentially hazardous interactions with acetazolamide, aminoglycosides, anticholinesterases, bambuterol, calcium channel blockers, chloroquine, chlorpromazine, clindamycin, d-pencillamine, ecothiophate iodine, enflurane, furosemide, halothane, hexomethonium, isoflurane, ketamine, lidocaine, lincomycin, lithium salts, magnesium salts, mannitol, MAO inhibitors, organophosphates, pancuronium, phenytoin, polymyxins, procainamide, quinidine, sevoflurane, spectinomycin, tetracyclines... 

The following drugs have been commonly associated with inducing, aggravating or unmasking SLE beta-blockers, carbamazepine, chlorpromazine, estrogens, griseofulvin, hydralazine, isoniazid (INH), lithium, methyldopa, minoxidil, oral contraceptives, penicillamine, phenytoin (diphenylhydantoin), procainamide, propylthiouracil, quinidine, and testosterone. 

Albumin X 4 X X HIV protease inhibitors, atenolol, cimetidine, chlorothiazide, chlorpromazine, losartan, phenytoin, tamoxifen, warfarin Aungst et al., 2000... 

Transporter efflux transporter effects predominant Examples Amiodarone Atorvastatin Azithromycin Carbamazepine Carvediioi Chlorpromazine Ciprofloxacin Cisapride Cyciosporine Danazoi Dapsone Diclofenac Diflunisal Digoxin Erythromycin Flurbiprofen Glipizide Glyburide Griseofulvin Ibuprofen Indinavir Indomethacin Itraconazole Ketoconazole Lansoprazole Lovastatin Mebendazole Naproxen Nelfinavir Ofloxacin Oxaprozin Phenazopyridine Phenytoin Piroxicam Raloxifene Ritonavir Saquinavir Saquinavir Sirolimus Sirolimus Spironolactone Spironolactone Tacrolimus Tacrolimus ... 

In addition to chlorpromazine, phenylbutazone (an analgesic and antiinflammatory agent), sulfonamides (chemotherapeutic agents), chlorothiazide (a diuretic), thiouracil and methima-zole (antithyroid drugs), phenytoin (an anticonvulsant), pyribenzamine (an antihistaminic), and chloramphenicol... 

Chlorpromazine increases the respiratory-depressant effects of meperidine, as do tricyclic antidepressants this is not true of diazepam. Concurrent administration of drugs such as promethazine or chlorpromazine also may greatly enhance meperidine-induced sedation without slowing clearance of the drug. Treatment with phenobar-bital or phenytoin increases systemic clearance and decreases oral bioavailability of meperidine this is associated with an elevation of the concentration of normeperidine in plasma. As with morphine, concomitant administration of an amphetamine has been reported to enhance the analgesic effects of meperidine and its congeners while counteracting sedation. 

Also analyzed acebutolol, acepromazine, acetaminophen, acetazolamide, acetophenazine, albuterol, amitriptyline, amobarbital, amoxapine, antipsrrine, atenolol, atropine, azata-dine, baclofen, benzocaine, bromocriptine, brompheniramine, brotizolam, bupivacaine, buspirone, butabarbital, butalbital, caffeine, carbamazepine, cetirizine, chlorqyclizine, chlordiazepoxide, chlormezanone, chloroquine, chlorpheniramine, chlorpromazine, chlorpropamide, chlorprothixene, chlorthalidone, chlorzoxazone, cimetidine, cisapride, clomipramine, clonazepam, clonidine, clozapine, cocaine, codeine, colchicine, qyclizine, (yclo-benzaprine, dantrolene, desipramine, diazepam, diclofenac, diflunisal, diltiazem, diphenhydramine, diphenidol, dipheno late, dipyridamole, disopyramide, dobutamine, doxapram, doxepin, droperidol, encainide, ethidium bromide, ethopropazine, fenoprofen, fentanyl, flavoxate, fluoxetine, fluphenazine, flurazepam, flurbiprofen, fluvoxamine, fii-rosemide, glutethimide, glyburide, guaifenesin, haloperidol, homatropine, hydralazine, hydrochlorothiazide, hydrocodone, hydromorphone, hydro g chloroquine, hydroxyzine, ibuprofen, imipramine, indomethacin, ketoconazole, ketoprofen, ketorolac, labetalol, le-vorphanol, lidocaine, loratadine, lorazepam, lovastatin, loxapine, mazindol, mefenamic acid, meperidine, mephenytoin, mepivacaine, mesoridazine, metaproterenol, methadone, methdilazine, methocarbamol, methotrexate, methotrimeprazine, methoxamine, methyl-dopa, methylphenidate, metoclopramide, metolazone, metoprolol, metronidazole, midazolam, moclobemide, morphine, nadolol, nalbuphine, naloxone, naphazoline, naproxen, nifedipine, nizatidine, norepinephrine, nortriptyline, oxazepam, oxycodone, oxymetazo-line, paroxetine, pemoline, pentazocine, pentobarbital, pentoxifylline, perphenazine, pheniramine, phenobarbital, phenol, phenolphthalein, phentolamine, phenylbutazone, phenyltoloxamine, phenytoin, pimozide, pindolol, piroxicam, pramoxine, prazepam, prazosin, probenecid, procainamide, procaine, prochlorperazine, procyclidine, promazine, promethazine, propafenone, propantheline, propiomazine, propofol, propranolol, protriptyline, quazepam, quinidine, quinine, racemethorphan, ranitidine, remoxipride, risperidone, salicylic acid, scopolamine, secobarbital, sertraline, sotalol, spironolactone, sulfinpyrazone, sulindac, temazepam, terbutaline, terfenadine, tetracaine, theophylline, thiethyl-perazine, thiopental, thioridazine, thiothixene, timolol, tocainide, tolbutamide, tolmetin, trazodone, triamterene, triazolam, trifluoperazine, triflupromazine, trimeprazine, trimethoprim, trimipramine, verapamil, warfarin, xylometazoline, yohimbine, zopiclone... 

Simultaneous chlordieizepoxide, chlorpromazine, cimetidine, clomipramine, diazepam, doxepin, flurazepam, lorazepeun, oxeizepam, p>entobarbital, perphenazine, phenobarbital, phenytoin, prochlorperazine, secobarbital, thioridazine, trifluoperazine Noninterfering acetaminophen, codeine, meperidine Interfering propoxyphene... 

Wong, S.H.Y. McHugh, S.L. Dolan, J. Cohen, K.A. Tricyclic antidepressant analysis by reversed-phase liquid chromatography using phenyl columns. J.Liq.Chromatogr., 1986, 9, 2511-2538 [also acetaminophen, amobarbital, amoxapine, barbital, chlordiazepoxide, chlorpromazine, cimetidine, clomipramine, codeine, desipramine, desmethyldoxepin, diazepam, doxepin, fluphenazine, flurazepam, glutethimide, hydroxyamoxapine, imipramine, lorazepam, maprotiline, meperidine, metabolites, nortriptyline, oxazepam, pentobarbital, perphenazine, phenobarbital, phenytoin, propoxyphene, protriptyline, secobarbital, thioridazine, trazodone]... 

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