Sibutramine Dextromethorphan

Dextromethorphan, meperidine, and pentazocine ° Amphetamine, fenfluoramine, dexfenfluoramine, methylphenidate, and cocaine ° Sibutramine, St. John s wort, ondansetron, granisetron, dolasetron, and palonosetron... 

Drugs that may interact with dextromethorphan include MAO inhibitors, quinidine, and sibutramine. 

Serotonin syndrome (sibutramine) The rare, but serious, constellation of symptoms also has been reported with the concomitant use of selective serotonin reuptake inhibitors and agents for migraine therapy (eg, sumatriptan, dihydroergotamine), certain opioids (eg, dextromethorphan, meperidine, pentazocine, fentanyl), lithium, or tryptophan. Because sibutramine inhibits serotonin reuptake, it should not be administered with other serotonergic agents. 

Dextromethorphan (Mediquell, Benylin DM, PediaCare 1, Delsym, Others) [OTC] [Antitussive] Uses Control nonproductive cough Action Suppresses medullary cough center Dose Adults. 10-30 mg PO q4h PRN (max 120 mg/24 h) Peds. 2-6 y 2.5-7.5 mg q4-8h (max 30 mg/24 h) 7-12 y 5-10 mg q4-8h (max 60 mg/24/h) Caution [C, /-] Not for persistent or chronic cough Contra < 2 y. Disp Caps, lozenges, syrup, Liq SE GI disturbances Interactions T Effects W/ amiodarone, fluoxetine, quinidine, terbinafme T risk of serotonin synd Wf sibutramine, MAOIs T CNS depression Wf antihistamines, antidepressants, sedative, opioids, EtOH EMS Will not affect cough caused by asthma,... 

Clinically important, potentially hazardous interactions with amitriptyline, amoxapine, clomipramine, desipramine, desvenlafaxine, dextromethorphan, doxepin, fluoxetine, fluvoxamine, imipramine, meperidine, nortriptyline, paroxetine, protriptyline, sertraline, sibutramine, trazodone, tricyclic antidepressants, trimipramine, venlafaxine... 

Clinically important, potentially hazardous interactions with amitriptyline, amoxapine, amphetamines, bupropion, citalopram, clomipramine, cyproheptadine, desipramine, dextroamphetamine, dextromethorphan, diethylpropion, dopamine, doxepin, entacapone, ephedra, ephedrine, epinephrine, fluoxetine, fluvoxamine, ginseng, imipramine, levodopa, mazindol, meperidine, methamphetamine, nefazodone, nortriptyline, paroxetine, phendimetrazine, phentermine, phenylephrine, pizotifen, propoxyphene, protriptyline, pseudoephedrine, rizatriptan, sertraline, sibutramine, sumatriptan, sympathomimetics, tramadol, tricyclic antidepressants, trimipramine, tryptophan, venlafaxine, zolmitriptan... 

Because sibutramine inhibits serotonin uptake, and because the serious serotonin syndrome has been seen when serotonergic drugs were taken with SSRIs, the manufacturers say that sibutramine should not be taken with any serotonergic drugs. They name dextromethorphan, dihydroergot-amine, fentanyl, pentazocine, pethidine (meperidine), SSRIs, sumatriptan, and tryptophan. Possible cases have been reported for sibutramine and SSMs , (below).The US manufacturers also include lithium in their list. Note that this list is not exhaustive (see MAOIs under (d) above) and a case of the serotonin syndrome has been seen when venla-faxine was given with sibutramine. ... 

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