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Can Diabetics Take Phenylephrine

Otc Cold Remedies: Phenylephrine And Diabetes

Otc Cold Remedies: Phenylephrine And Diabetes

OTC cold remedies: Phenylephrine and diabetes My wife has come down with the killer cold that is going around lately. She also has RA (taking Methotrexate) and recently was diagnosed with type 2 diabetes (Metformin 500mg). Most of the "dayquil" type cold and flu OTC gel tablets have phenylephrine in them. The included instructions warn to check with a Dr or pharmacist before using with diabetes. When I was at the store I asked the pharmacist on duty but she only spoke to the amount of sugar in the liquid medications, not the liquid gel tablets. She didn't seem familiar with the contraindications on the package. I'm not finding much else on why phenylephrine is contraindicated with diabetes. Hopefully you might have a little more experience with this than the pharmacist at the drug store. Chlorpheniramine Maleate - 2 mgAntihistamine , Acetaminophen (325 mg)Pain Reliever/Fever Reducer , Dextromethorphan HBr - 10 mgCough Suppressant , Phenylephrine HCl - 5 mgNasal Decongestant Nighttime: Corn Starch , FD&C Blue #1 Aluminum Lake , FD&C Blue #2 Aluminum Lake , Sodium Starch Glycolate , Daytime: Corn Starch , Croscarmellose Sodium , Crospovidone , Flavor , Magnesium Stearate , Microcrystalline Cellulose , Polyethylene Glycol , Polyvinyl Alcohol , Povidone , Silica Gel , Stearic Acid , Sucralose , Talc , Titanium Dioxide Continue reading >>

Phenylephrine - Side Effects, Dosage, Interactions - Drugs

Phenylephrine - Side Effects, Dosage, Interactions - Drugs

Phenylephrine is a nasal decongestant that provides relief from nasal discomfort caused by colds, allergies , and hay fever. It belongs to a class of drugs called vasopressors , and it works by reducing swelling of the blood vessels in the nose. Phenylephrine relieves symptoms but doesnt treat the cause of the symptoms or speed recovery. Its the active ingredient in dozens of generic products, including childrens cough medications and over-the-counter (OTC) drugs. Some of the most commonly used medications that contain phenylephrine include Neo-Synephrine, Sudafed PE, Vicks Sinex Nasal Spray, and Suphedrine PE. In 2011, the Food and Drug Administration (FDA) issued a safety alert about certain unapproved prescription cough, cold, and allergy products containing phenylephrine in combination with other drugs. These products are not currently approved by the FDA for safety, effectiveness, and quality. The FDA asked drug companies to stop shipping many of these products for sale in the United States due to concerns about improper use in young children, potentially risky combinations of phenylephrine, and reports of overuse through time-release products. You should not use medicines that contain phenylephrine if you have used a monoamine oxidase inhibitor (MAOI) in the past 14 days because of a potentially dangerous drug interaction. You should also ask a doctor if phenylephrine is safe to use if you have the following conditions: If you become pregnant while using phenylephrine, let your doctor know immediately. If your symptoms do not get better within 7 days of starting phenylephrine, or if you develop a fever, discontinue phenylephrine and call your doctor. Nonprescription cough and cold combination products, including those that contain phenylephrine, can cause serious Continue reading >>

2.5% And 10% Phenylephrine For Mydriasis In Diabetic Patients With Darkly Pigmented Irides

2.5% And 10% Phenylephrine For Mydriasis In Diabetic Patients With Darkly Pigmented Irides

You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. 2.5% and 10% Phenylephrine for Mydriasis in Diabetic Patients With Darkly Pigmented Irides The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. ClinicalTrials.gov Identifier: NCT00501878 Information provided by (Responsible Party): Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information To compare the clinical efficacy and systemic side effects between 2.5% and 10% phenylephrine for mydriasis in diabetic patient with darkly pigmented irides. One hundred patients with diabetes from Srinagarind Hospital Eye Clinic were enrolled and randomized into two groups by block randomization. In group I (50 patients), 1% tropicamide combined with 2.5% phenylephrine were administered to dilate pupil whereas 1% tropicamide combined with 10% phenylephrine were used in Group II (50 patients). Pupil diameter, blood pressure and heart rate were measured before and after eye drop instillations. 2.5% and 10% Phenylephrine for Mydriasis in Diabetic Patients With Darkly Pigmented Irides Pupil diameters were measured. [TimeFrame:before and after phenylephrine eye drop instillations] blood pressure and heart rate were measured [TimeFrame:before and after phenylephrine eye drop instillations] Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information Information from the National Library of Medicine Choosing to participate in a study is an i Continue reading >>

Are Over-the-counter Cold Remedies Safe For People Who Have High Blood Pressure?

Are Over-the-counter Cold Remedies Safe For People Who Have High Blood Pressure?

Over-the-counter cold remedies aren't off-limits if you have high blood pressure, but it's important to make careful choices. Among over-the-counter cold remedies, decongestants cause the most concern for people who have high blood pressure. Decongestants relieve nasal stuffiness by narrowing blood vessels and reducing swelling in the nose. This narrowing can affect other blood vessels as well, which can increase blood pressure. To keep your blood pressure in check, avoid over-the-counter decongestants and multisymptom cold remedies that contain decongestants — such as pseudoephedrine, ephedrine, phenylephrine, naphazoline and oxymetazoline. Instead: Choose a cold medication designed for people who have high blood pressure. Some cold medications, such as Coricidin HBP, don't contain decongestants. However, these medications may contain other powerful drugs, such as dextromethorphan, that can be dangerous if you take too much. Follow the dosing instructions carefully. Take a pain reliever. To relieve a fever, sore throat or headache or body aches, try aspirin or acetaminophen (Tylenol, others). Use saline nasal spray. To relieve nasal congestion, try saline nasal spray. The spray can help flush your sinuses. Soothe your throat. To relieve a sore or scratchy throat, gargle with warm salt water or drink warm water with lemon juice and honey. Drink plenty of fluids. Water, juice, tea and soup can help clear your lungs of phlegm and mucus. Increase the humidity in your home. Use a cool-mist humidifier or vaporizer to moisten the air, which may ease congestion and coughing. Get plenty of rest. If you're not feeling well, take it easy. Call your doctor if your signs and symptoms get worse instead of better or last more than 10 days. Continue reading >>

Are Cough And Cold Products Safe For People With Diabetes?

Are Cough And Cold Products Safe For People With Diabetes?

It's that time of year again. Stuffy noses, scratchy throats, upset tummies, and splitting headaches can send even the most stoic among us to the local drugstore for a magic pill to take away the pain. The fluorescent aisles of brightly colored bottles promising fast relief can seem daunting. Are all over-the-counter cold and flu meds safe for people with diabetes? Many over-the-counter cough, cold, and flu remedies list diabetes as an underlying condition that may indicate you should leave the medication on the shelf. The warnings are clear: "Ask a doctor before use if you have: heart disease, high blood pressure, diabetes." Unfortunately, your doctor is not along for the trip to the pharmacy. Most experts agree that most people with diabetes can feel free to select whatever over-the-counter (OTC) product works best for them, so long as the medication is taken as directed. At the same time, everyone is different so it's important to shop smartly to ensure a quick and safe recovery from this season's infections. Because illness causes your body to release stress hormones that naturally raise blood glucose, you'll want to be sure that over-the-counter medications won't increase blood glucose levels, too. Ask the Pharmacist Don't just wander around the drugstore dazed and confused. "When making these choices, this is a time to utilize a pharmacist…This is what they are trained for…Tell the pharmacist all your symptoms, what other medicines you are taking,” says Jerry Meece, RPh, FACA, CDE, director of clinical services at the Plaza Pharmacy and Wellness Center in Gainesville, Texas." Meter/Monitor Accuracy There's been concern that certain OTC medications can cause false blood glucose readings. "Ten years ago, as companies were changing the process by which they mon Continue reading >>

Drugs That Can Raise Bg

Drugs That Can Raise Bg

By the dLife Editors Some medicines that are used for treating other medical conditions can cause elevated blood sugar in people with diabetes. You may need to monitor your blood glucose more closely if you take one of the medicines listed below. It’s important to note that just because a medicine has the possibility of raising blood sugar, it does not mean the medicine is unsafe for a person with diabetes. For instance, many people with type 2 diabetes need to take a diuretic and a statin to lower blood pressure and cholesterol. In these and many other cases, the pros will almost always outweigh the cons. Don’t ever take matters of medication into your own hands. Discuss any concerns you have with your healthcare provider. Certain Antibiotics Of all the different antibiotics, the ones known as quinolones are the only ones that may affect blood glucose. They are prescribed for certain types of infection. Levofloxacin (Levaquin) Ofloxacin (Floxin) Moxifloxacin (Avelox) Ciprofloxacin (Cipro, Cipro XR, Proquin XR) Gemifloxacin (Factive) Second Generation Antipsychotics These medicines are used for a variety of mental health conditions. There is a strong association between these medicines and elevated blood sugar, and frequent monitoring is recommended. Clozapine (Clozaril) Olanzapine (Zyprexa) Paliperidone (Invega) Quietiapine (Seroquel, Seroquel XR) Risperidone (Risperdal) Aripiprazole (Abilify) Ziprasidone (Geodon) Iloperidone (Fanapt) Lurasidone (Latuda) Pemavanserin (Nuplazid) Asenapine (Saphris) Beta Blockers Beta blockers are used to treat high blood pressure and certain heart conditions. Not all available beta blockers have been shown to cause high blood sugar. Atenolol Metoprolol Propranolol Corticosteroids Corticosteroids are used to treat conditions where th Continue reading >>

Cold Medicines That Are Safe For Diabetes

Cold Medicines That Are Safe For Diabetes

Safe OTC Cold Medicines Various over-the-counter medications are designed to treat specific symptoms. Many pharmacists recommend these products for people with diabetes. Symptom: Cough Best option: Anti-tussive dextromethorphan (Delsym, Diabetic Tussin NT [includes acetaminophen, diphenhydramine]) Symptoms: Congestion, mucus in sinus passages Best options: Decongestant pseudoephedrine (Sudafed); phenylephrine; phenylpropalamine Symptoms: Phlegm, mucus in respiratory tract Best option: Expectorant guaifenesin (Mucinex, Robitussin) Symptoms: Pain and/or fever Best options: Analgesic acetaminophen (Tylenol); aspirin For fever and pain relief, look to analgesics, including aspirin and acetaminophen. Both are safe for most people and commonly available. The analgesic class of nonsteroidal anti-inflammatory drugs (NSAIDS), which includes ibuprofen and naproxen, may increase blood pressure and is not a good choice for people with kidney problems. Note: Be sure to call your doctor if your temperature rises above 103 degrees Fahrenheit. Symptoms: Runny nose, itchy eyes Best option: Antihistamine Less-sedating options: certirizine (Zyrtec); loratadine (Claritin) More-sedating options: chlorpheniramine (Chlortrimeton); diphenhydramine (Benadryl) For a stuffy nose, oral decongestants (pseudoephedrine, phenylephrine, phenylpropalamine) can increase both blood glucose and blood pressure and therefore are not usually recommended. "The occasional use of a decongestant should be the rule," says Robert Busch, M.D., an endocrinologist from Albany, New York. You'll have to sign the pharmacy register for over-the-counter remedies containing pseudoephedrine. Federal law limits pseudoephedrine purchases because the drug can be used to make illegal methamphetamine. All oral antihistamines are Continue reading >>

Treating The Common Cold And Type 2 Diabetes

Treating The Common Cold And Type 2 Diabetes

It is that time of year again and as a Pharmacist/Certified Diabetes Educator one of the most common questions over the fall, the holiday’s and winter months is “What do you have to treat my cold?” or simply “Can you make me feel better?” Well there is no cure and we cannot wave our “therapeutic” wand and make symptoms disappear but there are a variety of products to help with the symptoms of cough and cold. If the patient is relatively healthy it may be a bit of a hit or miss scenario but usually the product will ease the symptoms until the cold runs its course over 7 to 10 days. The picture becomes less clear when the patient is taking other medications, has medical conditions such as kidney disease, blood pressure, or they have diabetes. Assisting our patient choose an appropriate product that will not worsen their existing medical conditions, and lessen the symptoms that make them feel miserable is key. Diabetes is a condition that requires some adjusting to choose the right product. It is not always a “Sugar free”, “Natural”, or alternative product that is best, as active ingredients may have issues. These include raising blood sugars, raising blood pressure or stressing the kidneys (common issues with diabetes). Usually after a brief discussion to educate the patient, a product can be chosen to help both their symptoms and minimally impact their diabetes and blood sugars. The discussion that follows is a practical approach on how to decide what a person with diabetes can use so that they understand why we avoid certain classes of products due to a their existing medical conditions. Blood Sugars Can Rise when Ill It is important to realize that when a person with diabetes is “fighting” a cold it produces stresses on the body as a whole and Continue reading >>

Cold Medicines That Are Safe For Diabetes

Cold Medicines That Are Safe For Diabetes

Searching for relief for your runny nose, sore throat, or cough? Many over-the-counter cough, cold, and flu remedies list diabetes as an underlying condition that may indicate you should leave the medication on the shelf. The warnings are clear: "Ask a doctor before use if you have: heart disease, high blood pressure, diabetes." Unfortunately, your doctor is not along for the trip to the pharmacy. Because illness causes your body to release stress hormones that naturally raise blood glucose, you'll want to be sure that over-the-counter medications won't increase blood glucose levels, too. Simple Is Best for Cold Medicines Keep it simple by choosing an over-the-counter medication based on the types of ingredients proven to relieve your particular symptoms. Often a medication with just one ingredient is all you need to treat your symptoms rather than agents with multiple ingredients. "To choose the correct medication, take time to speak to a pharmacist," says Jerry Meece, R.Ph., CDE, of Gainesville, Texas. "The proper remedies may not only make you feel better, but also cut the length of the illness and possibly save you a trip to the doctor." Oral cold and flu pills are often a better choice than syrups with the same ingredients because the pills may contain no carbohydrate. If you decide to use a syrup, look for one that is sugar-free. If you can't find one, the small amount of sugar in a syrup will likely affect your blood sugar less than the illness itself, Meece says. Safe OTC Cold Medicines Various over-the-counter medications are designed to treat specific symptoms. Many pharmacists recommend these products for people with diabetes. Symptom: Cough Best option: Anti-tussive dextromethorphan (Delsym, Diabetic Tussin NT [includes acetaminophen, diphenhydramine]) Sympt Continue reading >>

Pseudoephedrine (oral Route)

Pseudoephedrine (oral Route)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered: Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Pseudoephedrine may be more likely to cause side effects in infants, especially newborn and premature infants, than in older children and adults. Do not give any over-the-counter (OTC) cough and cold medicine to a baby or child under 4 years of age. Using these medicines in very young children might cause serious or possibly life-threatening side effects . Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of pseudoephedrine in the elderly with use in other age groups. Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been s Continue reading >>

Phenylephrine Disease Interactions

Phenylephrine Disease Interactions

There are 4 disease interactions with phenylephrine: Sympathomimetics (Includes Phenylephrine) Cardiovascular Disease Severe Potential Hazard, High plausibility Applies to: Cardiovascular Disease, Cerebrovascular Insufficiency, Hyperthyroidism, Pheochromocytoma Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension. Covington TR, Lawson LC, Young LL, eds. "Handbook of Nonprescription Drugs. 10th ed." Washington, DC: American Pharmaceutical Association (1993): Horowitz JD, Lang WJ, Howes LG, Fennessy MR, Christophidis N, Rand MJ, Louis WJ "Hypertensive responses induced by phenylpropanolamine in anorectic and decongestant preparations." Lancet 1 (1980): 60-1 Frewin DB "Phenylpropanolamine. How safe is Continue reading >>

Voice Of The Diabetic

Voice Of The Diabetic

by Sarah Johnston Miller, Pharm.D., BCNSP (Note from Dr. Wes Wilson: Looking at this question, I felt it would be wise to refer it to a pharmacist who is actively involved in both patient care and in teaching students about such problems. Dr. Sarah Miller is Professor of Clinical Pharmacy at the University of Montana, and is also a consultant at St. Patrick Hospital in Missoula, Montana. Her answer should be helpful.) Q: Which nonprescription drug products for treatment of common cold symptoms should a person with diabetes avoid? A: There is some concern about the effect some nonprescription (over-the-counter) medications may have on blood sugar control. The diabetic patient should always remember that, in general, "sick days" may be associated with fluctuations in blood sugar. This may be related to the stress of being sick, or to changes in dietary intake during illness. Your nonprescription medications may not be at fault at all--but it pays to know. A severe bout of the common cold (a viral illness) could certainly produce "sick days," elevated blood sugars--without any effects from your nonprescription or other medications. When you're sick, test your blood more often. Textbooks may list quite a few classes of potentially-problematic medications, though many of these are in reality not very significant. Regardless, the diabetic patient should always contact their health care provider (physician, diabetes educator, or pharmacist) prior to taking any new nonprescription medication. This includes "lternative"remedies purchased at the health food store or elsewhere; "natural" does not mean "safe from interactions!" You should be cautious that many nonprescription medications, including those targeting symptoms of the common cold, contain multiple ingredients. Another Continue reading >>

Sneezes And Wheezes: Seasonal Allergies And Diabetes

Sneezes And Wheezes: Seasonal Allergies And Diabetes

Spring is really starting to burst out here in Massachusetts. The tulips are blooming and leaves and buds are popping out on the trees. As pretty and welcoming as this is, many of you (about 50 million!) are probably bracing yourself for all of the pollen that is soon to follow, and suffering through the misery that it can bring. Thanks to the mild winter that we had in the Northeast, plants are pollinating earlier than usual. As if that weren’t bad enough, having seasonal allergies can also affect your blood sugar control. Seasonal allergies: do you have them? Seasonal allergies are sometimes called hay fever or, more technically, seasonal allergic rhinitis. You might be wondering if your symptoms are due to a cold, flu, or allergies. While there can be some overlap, the following symptoms are usually indicative of allergies: • Itchy eyes • Watery eyes • Dark circles under the eyes • Sneezing • Runny nose • Stuffy nose • Sore throat You might also feel a little bit tired. You won’t get a fever from allergies, however. These symptoms can linger for weeks unless they’re treated. Treating allergies There are a number of remedies for seasonal allergies, including oral medications, nasal sprays, and eye drops. It’s important that you not only choose the right one for your symptoms, but that you also are aware of how these medicines might affect your blood sugars. The following types of allergy medicines may affect your blood glucose levels or how you manage them: Antihistamines. These medicines can reduce sneezing, runny nose, and itchy and watery eyes. Common antihistamines include diphenhydramine (Benadryl), loratidine (Alavert, Claritin), cetirizine (Zyrtec Allergy), and fexofenadine (Allegra Allergy). Antihistamines might be combined with a deconge Continue reading >>

Drug Interactions With Diabetes

Drug Interactions With Diabetes

Patients with diabetes often receive many other medications in addition to their oral or injectable diabetes agents. If confronted with a loss of glycemic control, providers should investigate whether or not concomitant drug therapy may be contributing. This is of particular consideration when starting a new medication or increasing dosages. The theorized mechanisms for these interactions include decreased peripheral insulin sensitivity, decreased insulin secretion and/or increased gluconeogenesis. This article summarizes information on a core group of medications to be suspected in cases of decreased glycemic control. Corticosteroids The route of administration and the dose are factors that determine the impact of this class on blood glucose. Lower risk is associated with inhaled and topical formulations vs. oral formulations. The effect on blood glucose may be dramatic and prolonged, requiring dose increases in diabetes medications to achieve glycemic control during concomitant therapy. Atypical antipsychotics These medications have been frequently reported to be associated with significant increases in weight, diabetes (even diabetic ketoacidosis) and may have an adverse effect on lipids. The weight gain appears to be rapid, within the first few months of therapy, but may not plateau for as long as one year after treatment initiation. The increase in weight is widely variable (2 to 10 kg) and is reportedly due to an increase in body fat, suggesting insulin resistance as the mechanism. The relative risk of hyperglycemia and weight gain varies between agents within this class. Clozapine (Clozaril, Novartis) and olanzepine (Zyprexa, Eli Lilly) appear to be ranked highest. Switching patients to the lowest risk agents aripiprazole (Abilify, Otsuka America/Bristol-Myers Sq Continue reading >>

Phenylephrine

Phenylephrine

Ah-Chew D, Dimetapp Cold Drops, Lusonal, Nasop, Nasop12, PediaCare Children's Decongestant, Phenyl-T, Sudafed PE, Sudafed PE Children's Nasal Decongestant, Sudafed PE Quick Dissolve, Sudogest PE, Triaminic Thin Strips Cold What is the most important information I should know about phenylephrine? Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. You should not use this medication if you are allergic to phenylephrine. Do not use phenylephrine if you have used linezolid (Zyvox) or procarbazine (Matulane), or if you have taken a monoamine oxidase inhibitor (MAOI) such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) in the last 14 days. Serious, life-threatening side effects can occur if you take phenylephrine before these other drugs have cleared from your body. Before you take phenylephrine, tell your doctor if you are allergic to any decongestants, or if you have heart disease, heart rhythm disorder, high blood pressure, circulation problems, diabetes, glaucoma, a thyroid disorder, kidney disease, an enlarged prostate or urination problems, anxiety, sleep problems, bipolar disorder or other mental illness. Phenylephrine may interact with heart or blood pressure medications, antidepressants, diabetes medications, migraine headache medications, and other decongestants. Never take more of the medicine than directed on the label or prescribed by your doctor. Call your doctor if your symptoms do not improve after 7 days of using phenylephrine, or if they get worse and your also have a fever. Phenylephrin Continue reading >>

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