5 Interactions found for:
Drug Interactions
No drug interactions were found for selected drugs: ProAir HFA, montelukast.
This does not necessarily mean no interactions exist. Always consult your healthcare provider.
Drug and Food Interactions
Moderate
Proair Hfa
+ Food
The following applies to the ingredients: Albuterol (found in Proair Hfa)
MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.
MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.
References
- Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res 1 (1979): 45-52
- Cavanaugh JH, Griffith JD, Oates JA "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther 11 (1970): 656
- "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc PROD (2001):
- "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals PROD (2001):
- "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals PROD (2001):
- "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
- "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
Drug and Pregnancy Interactions
Major
Proair Hfa
+ Pregnancy
The following applies to the ingredients: Albuterol (found in Proair Hfa)
The manufacturer makes no recommendation regarding use during pregnancy.
AU TGA pregnancy category: A
US FDA pregnancy category: Not assigned
Comments:
-There are no randomized clinical studies of albuterol use during pregnancy, but available information on pregnancy exposure by inhalation do not consistently show miscarriage or major birth defects.
-This drug is known to cross the placental barrier, as evidenced by increases in fetal heart rate.
-Beta-agonists, including this drug, may potentially interfere with uterine contractility.
-In women with poorly or moderately controlled asthma, there is an increased risk of preeclampsia in the mother and prematurity, low birth weight, and small for gestational age in the neonate. Pregnant women should be closely monitored and the dose adjusted as necessary to maintain optimal control.
-In some countries, intravenous injection presentations of this drug have been approved for delay pre-term labor (tocolytic agent) and should not be used in the management of uncomplicated premature labor.
Epidemiological studies and postmarketing case reports following inhaled administration of this drug do not consistently demonstrate a risk of major birth defects or miscarriage. In animal reproduction studies, subcutaneous administration to pregnant mice evidence of cleft palate at less than and up to 9 times the maximum recommended human daily inhalation dose (MRHDID). A study in pregnant rats demonstrated that drug-related material was transferred from the maternal circulation to the fetus. There are no controlled data in human pregnancy.
During worldwide marketing experience, various congenital anomalies, including cleft palate and limb defects, have been reported in the offspring of patients being treated with this drug. Some of the mothers were taking multiple medications during their pregnancies. A relationship between the use of this drug and congenital anomalies has not been established. Profuse uterine bleeding following spontaneous abortion has been reported after the use of this drug. Special care is required in pregnant diabetic women. The background birth defect and miscarriage risk for the indicated population is not known. In the US general population, the estimated major birth defect risk is 2 to 4% and the miscarriage risk is 15 to 20%.
A pregnancy exposure registry monitors outcomes after exposure to asthma medications during pregnancy. For more information, contact the Mothers To Baby Pregnancy Studies conducted by the Organization of Teratology Information Specialists at http://mothertobaby.org/pregnancystudies/.
AU TGA pregnancy category A: Drugs which have been taken by a large number of pregnant women and women of childbearing age without any proven increase in the frequency of malformations or other direct or indirect harmful effects on the fetus having been observed.
US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.
References
- Lunell NO, Joelsson I, Bjorkman U, Lamb P, Persson B "The use of salbutamol in obstetrics." Acta Obstet Gynecol Scand 55 (1976): 333-6
- Davies AE, Robertson MJ "Pulmonary oedema after the administration of intravenous salbutamol and ergometrine. Case report." Br J Obstet Gynaecol 87 (1980): 539-41
- Watson NA, Morgan B "Pulmonary oedema and salbutamol in preterm labour. Case report and literature review." Br J Obstet Gynaecol 96 (1989): 1445-8
- Lind T, Godfrey KA, Gerrard J, Bryson MR "Continuous salbutamol infusion over 17 weeks to pre-empt premature labour." Lancet 2 (1980): 1165-6
- Tan SN "Peri-partum pulmonary oedema." Anaesth Intensive Care 19 (1991): 111-3
- Hawker F "Five cases of pulmonary oedema associated with beta 2-sympathomimetic treatment of premature labour." Anaesth Intensive Care 12 (1984): 159-62
- Martin AJ "Severe unwanted effects associated with betasympathomimetics when used in the treatment of premature labour: causes, incidence and preventative measures." Br J Clin Pract 35 (1981): 325-9
- "Product Information. Proventil (albuterol)." Schering Corporation PROD (2002):
- "Product Information. Ventolin (albuterol)." Glaxo Wellcome PROD (2002):
- Rayburn WF, Atkinson BD, Gilbert K, Turnbull GL "Short-term effects of inhaled albuterol on maternal and fetal circulations." Am J Obstet Gynecol 171 (1994): 770-3
- Mcdonald CF, Burdon JGW "Asthma in pregnancy and lactation - a position paper for the thoracic society of australia and new zealand." Med J Aust 165 (1996): 485-8
- Dombrowski MP "Pharmacologic therapy of asthma during pregnancy." Obstet Gynecol Clin North Am 24 (1997): 559
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Albuterol Extended Release (albuterol)." Dava Pharmaceuticals Inc (2022):
- "Product Information. Albuterol Sulfate (albuterol)." Vista Pharm Inc (2022):
- "Product Information. Albuterol (albuterol)." Physicians Total Care (2022):
Minor
Montelukast
+ Pregnancy
The following applies to the ingredients: Montelukast
The manufacturer makes no recommendation regarding use during pregnancy.
AU TGA pregnancy category: B1
US FDA pregnancy category: Not assigned
Comments:
-Available data from decades of studies have not established a drug-associated increase in major birth defects when used during pregnancy.
-Animal studies at up to 110 times the maximum recommended human daily oral dose administered during organogenesis did not show adverse developmental effects.
-Poorly or moderately controlled asthma increases maternal risk and the risk of adverse perinatal outcomes (e.g. preeclampsia, prematurity, low birth weight, small for gestational age).
Animal studies of oral administration during organogenesis at up to 110 times the maximum recommended human daily oral dose did not cause any averse developmental effects. Human data from prospective and retrospective cohort studies have not identified an increase in major birth defects when this drug was used during pregnancy; limitations of the studies include small sample size, retrospective data collection, and inconsistent comparator groups. There are no controlled data in human pregnancy. The background birth defect and miscarriage risk for the indicated population is not known. In the US general population, the estimated major birth defect risk is 2 to 4% and the miscarriage risk is 15 to 20%.
AU TGA pregnancy category B1: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have not shown evidence of an increased occurrence of fetal damage.
US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.
References
- "Product Information. Singulair (montelukast)." Merck & Co., Inc PROD (2001):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- Sarkar M, Koren G, Kalra S, et al. "Montelukast use during pregnancy: a multicentre, prospective, comparative study of infant outcomes." Eur J Clin Pharmacol 65 (2009): 1259-64
- "Product Information. Montelukast Sodium (montelukast)." Ajanta Pharma USA (2016):
Drug and Breastfeeding Interactions
Major
Proair Hfa
+ Breastfeeding
The following applies to the ingredients: Albuterol (found in Proair Hfa)
The manufacturer makes no recommendation regarding use during lactation.
Excreted into human milk: Unknown
Excreted into animal milk: Data not available
Comments:
-There is no information regarding this drug on the presence in human milk, the effects on a breastfed infant, or effects on milk production.
-Consider the developmental and health benefits of breastfeeding along with the mother's clinical need for this medication as well as any potential adverse effects from this drug or the underlying maternal condition.
References
- "Product Information. Proventil (albuterol)." Schering Corporation PROD (2002):
- "Product Information. Ventolin (albuterol)." Glaxo Wellcome PROD (2002):
- Mcdonald CF, Burdon JGW "Asthma in pregnancy and lactation - a position paper for the thoracic society of australia and new zealand." Med J Aust 165 (1996): 485-8
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Albuterol Extended Release (albuterol)." Dava Pharmaceuticals Inc (2022):
- "Product Information. Albuterol Sulfate (albuterol)." Vista Pharm Inc (2022):
- "Product Information. Albuterol (albuterol)." Physicians Total Care (2022):
Minor
Montelukast
+ Breastfeeding
The following applies to the ingredients: Montelukast
The manufacturer makes no recommendation regarding use during lactation.
Excreted into human milk: Yes
Comments:
-A published study reports presence of this drug in human milk.
-Available data do not suggest significant risk of adverse events in the infant from exposure through breast milk or direct exposure.
-There is no information regarding this drug on the effects on milk production.
-Consider the developmental and health benefits of breastfeeding along with the mother's clinical need for this medication as well as any potential adverse effects from this drug or the underlying maternal condition.
References
- "Product Information. Singulair (montelukast)." Merck & Co., Inc PROD (2001):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Montelukast Sodium (montelukast)." Ajanta Pharma USA (2016):
Therapeutic Duplication Warnings
No warnings were found for your selected drugs.Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
Switch to: Consumer Interactions
Drug Interaction Classification | |
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These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication. |
|
Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Unknown | No interaction information available. |
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