Brompheniramine; Phenylephrine: (Moderate) Additive CNS depression may occur if barbiturates are co-used with sedating antihistamines, reminiscent of brompheniramine. Monitor for additive CNS and respiratory effects, and warn about the potential results to driving and different activities. (Reasonable) CNS-stimulating actions of caffeine will be additive with different CNS stimulants or psychostimulants like phenylephrine; caffeine ought to be averted or used cautiously. Excessive caffeine ingestion (through medicines, supplements or drinks including espresso, green tea, dihydrocodeine 30mg po polsku other teas, guarana, colas) could contribute to unintended effects like nervousness, irritability, insomnia, or tremor.
Chloramphenicol: (Major) Avoid chloramphenicol for two weeks prior to and through therapy with ketoconazole. Concomitant use might enhance publicity of ketoconazole and increase the chance of opposed effects. If concomitant use is necessary, monitor carefully for ketoconazole-related adversarial reactions; a ketoconazole dose discount may be necessary. Ketoconazole is a CYP3A substrate and chloramphenicol is a strong CYP3A inhibitor.
Cyclosporine: (Reasonable) Monitor renal function throughout concomitant therapy. Cyclosporine serum concentrations needs to be monitored and suitable dosage adjustments made. Coadministration of ciprofloxacin and cyclosporine could lead to elevated plasma cyclosporine concentrations. Cyclosporine is extensively metabolized by CYP3A4; ciprofloxacin is an inhibitor of CYP3A4. Additionally, some quinolones, including ciprofloxacin, have been associated with transient elevations in serum creatinine in patients receiving concomitant cyclosporine and ciprofloxacin therapy and may potentiate renal dysfunction. Circumstances of nephrotoxicity with and with out will increase in cyclosporine concentrations throughout concurrent cyclosporine and ciprofloxacin treatment have been reported.