Dosing & Uses
Dosage Forms & Strengths
acrivastine/pseudoephedrine
capsule
- 8mg/60mg
Seasonal Allergic Rhinitis or Nasal Congestion
8 mg/60 mg (1 capsule) PO q4-6h
>14 days continuous treatment efficacy not adequately investigated
Renal Impairment
CrCl>48mL/min: Dose adjustment not necessary
CrCl <48mL/min: Not recommended
Hepatic Impairment
Not studied
Dosage Forms & Strengths
acrivastine/pseudoephedrine
capsule
- 8mg/60mg
Seasonal Allergic Rhinitis or Nasal Congestion
<12 years: Safety and efficacy not established
>12 years: 8 mg/60 mg (1 capsule) PO q4-6h
>14 days continuous treatment efficacy not adequately investigated
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (16)
- dihydroergotamine
dihydroergotamine increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Ergot derivatives may enhance the vasoconstricting effect of pseudoephedrine and eventually significantly increasing blood pressure.
- dihydroergotamine inhaled
dihydroergotamine inhaled increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Ergot derivatives may enhance the vasoconstricting effect of pseudoephedrine and eventually significantly increasing blood pressure.
- dihydroergotamine intranasal
dihydroergotamine intranasal increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Ergot derivatives may enhance the vasoconstricting effect of pseudoephedrine and eventually significantly increasing blood pressure.
- ergoloid mesylates
ergoloid mesylates increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Ergot derivatives may enhance the vasoconstricting effect of pseudoephedrine and eventually significantly increasing blood pressure.
- ergonovine
ergonovine increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Ergot derivatives may enhance the vasoconstricting effect of pseudoephedrine and eventually significantly increasing blood pressure.
- ergotamine
ergotamine increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Ergot derivatives may enhance the vasoconstricting effect of pseudoephedrine and eventually significantly increasing blood pressure.
- isocarboxazid
isocarboxazid increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- linezolid
linezolid increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- methylergonovine
methylergonovine increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Ergot derivatives may enhance the vasoconstricting effect of pseudoephedrine and eventually significantly increasing blood pressure.
- phenelzine
phenelzine increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- procarbazine
procarbazine increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- rasagiline
rasagiline increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- selegiline
selegiline increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- selegiline transdermal
selegiline transdermal increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- thalidomide
acrivastine and thalidomide both increase sedation. Contraindicated.
- tranylcypromine
tranylcypromine increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
Serious - Use Alternative (51)
- alfentanil
acrivastine and alfentanil both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- amisulpride
amisulpride and acrivastine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- amitriptyline
amitriptyline increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- amoxapine
amoxapine increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- benzhydrocodone/acetaminophen
acrivastine and benzhydrocodone/acetaminophen both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- buprenorphine
acrivastine and buprenorphine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- buprenorphine buccal
acrivastine and buprenorphine buccal both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- buprenorphine subdermal implant
acrivastine and buprenorphine subdermal implant both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
buprenorphine subdermal implant and acrivastine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate - buprenorphine transdermal
acrivastine and buprenorphine transdermal both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- buprenorphine, long-acting injection
acrivastine and buprenorphine, long-acting injection both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- cabergoline
cabergoline, pseudoephedrine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.
- clomipramine
clomipramine increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- cocaine topical
cocaine topical increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug.
- codeine
acrivastine and codeine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- desipramine
desipramine increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- desvenlafaxine
desvenlafaxine increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug.
- deutetrabenazine
acrivastine and deutetrabenazine both increase sedation. Avoid or Use Alternate Drug.
- doxapram
doxapram increases effects of pseudoephedrine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- doxepin
doxepin increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- duloxetine
duloxetine increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug.
- fentanyl
acrivastine and fentanyl both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- fentanyl intranasal
acrivastine and fentanyl intranasal both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- fentanyl iontophoretic transdermal system
acrivastine and fentanyl iontophoretic transdermal system both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- fentanyl transdermal
acrivastine and fentanyl transdermal both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- fentanyl transmucosal
acrivastine and fentanyl transmucosal both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- hydrocodone
acrivastine and hydrocodone both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- hydromorphone
acrivastine and hydromorphone both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- imipramine
imipramine increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- iobenguane I 123
pseudoephedrine decreases effects of iobenguane I 123 by receptor binding competition. Avoid or Use Alternate Drug. If clinically appropriate, discontinue drugs that compete for NE receptor sites for at least 5 half-lives; may cause false-negative imaging results. Do not administer pseudoephedrine until at least 7 days after each iobenguane dose.
- iobenguane I 131
pseudoephedrine decreases effects of iobenguane I 131 by receptor binding competition. Avoid or Use Alternate Drug. If clinically appropriate, discontinue drugs that compete for NE receptor sites for at least 5 half-lives; may cause false-negative imaging results. Do not administer pseudoephedrine until at least 7 days after each iobenguane dose.
- isoflurane
isoflurane increases toxicity of pseudoephedrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- levomilnacipran
levomilnacipran increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug.
- lofepramine
lofepramine, pseudoephedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- maprotiline
maprotiline, pseudoephedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- methadone
acrivastine and methadone both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- methocarbamol
acrivastine and methocarbamol both increase sedation. Avoid or Use Alternate Drug.
- methoxyflurane
methoxyflurane increases toxicity of pseudoephedrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- metoclopramide intranasal
acrivastine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
- milnacipran
milnacipran increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug.
- morphine
acrivastine and morphine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- nortriptyline
nortriptyline increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- oxycodone
acrivastine and oxycodone both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- oxymorphone
acrivastine and oxymorphone both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- ozanimod
ozanimod increases toxicity of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.
- protriptyline
protriptyline increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- selinexor
selinexor, acrivastine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.
- sevoflurane
sevoflurane increases toxicity of pseudoephedrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- tramadol
acrivastine and tramadol both increase sedation. Avoid or Use Alternate Drug.
- trazodone
trazodone, pseudoephedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- triazolam
acrivastine and triazolam both increase sedation. Avoid or Use Alternate Drug.
- trimipramine
trimipramine increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
Monitor Closely (220)
- acetaminophen/phenyltoloxamine
acrivastine and acetaminophen/phenyltoloxamine both increase sedation. Use Caution/Monitor.
- acetazolamide
acetazolamide will increase the level or effect of pseudoephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- albuterol
albuterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- alfuzosin
pseudoephedrine decreases effects of alfuzosin by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- alprazolam
acrivastine and alprazolam both increase sedation. Use Caution/Monitor.
- aluminum hydroxide
aluminum hydroxide will increase the level or effect of pseudoephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor. Caution advised with frequent or high dose antacids
- amisulpride
acrivastine and amisulpride both increase sedation. Use Caution/Monitor.
- amitriptyline
acrivastine and amitriptyline both increase sedation. Use Caution/Monitor.
- ammonium chloride
ammonium chloride decreases effects of pseudoephedrine by unknown mechanism. Use Caution/Monitor. Urinary excretion of indirect acting alpha/beta agonists (eg, pseudoephedrine) may increase when administered concomitantly with urinary acidifying agents, resulting in lower serum concentrations.
- amobarbital
acrivastine and amobarbital both increase sedation. Use Caution/Monitor.
- amoxapine
acrivastine and amoxapine both increase sedation. Use Caution/Monitor.
- arformoterol
arformoterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- aripiprazole
acrivastine and aripiprazole both increase sedation. Use Caution/Monitor.
- asenapine
acrivastine and asenapine both increase sedation. Use Caution/Monitor.
- asenapine transdermal
acrivastine and asenapine transdermal both increase sedation. Use Caution/Monitor.
- avapritinib
acrivastine and avapritinib both increase sedation. Use Caution/Monitor.
- baclofen
acrivastine and baclofen both increase sedation. Use Caution/Monitor.
- benzphetamine
benzphetamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- brexanolone
brexanolone, acrivastine. Either increases toxicity of the other by sedation. Use Caution/Monitor.
acrivastine and brexanolone both increase sedation. Use Caution/Monitor. - brexpiprazole
acrivastine and brexpiprazole both increase sedation. Use Caution/Monitor.
- brimonidine
acrivastine and brimonidine both increase sedation. Use Caution/Monitor.
- brivaracetam
acrivastine and brivaracetam both increase sedation. Use Caution/Monitor.
- bromocriptine
bromocriptine, pseudoephedrine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Hypertension, V tach.
- brompheniramine
acrivastine and brompheniramine both increase sedation. Use Caution/Monitor.
- butabarbital
acrivastine and butabarbital both increase sedation. Use Caution/Monitor.
- butalbital
acrivastine and butalbital both increase sedation. Use Caution/Monitor.
- butorphanol
acrivastine and butorphanol both increase sedation. Use Caution/Monitor.
- carbinoxamine
acrivastine and carbinoxamine both increase sedation. Use Caution/Monitor.
- cariprazine
acrivastine and cariprazine both increase sedation. Use Caution/Monitor.
- carisoprodol
acrivastine and carisoprodol both increase sedation. Use Caution/Monitor.
- cenobamate
cenobamate, acrivastine. Either increases effects of the other by sedation. Use Caution/Monitor.
acrivastine and cenobamate both increase sedation. Use Caution/Monitor. - cetirizine
acrivastine and cetirizine both increase sedation. Use Caution/Monitor.
- chlordiazepoxide
acrivastine and chlordiazepoxide both increase sedation. Use Caution/Monitor.
- chlorpheniramine
acrivastine and chlorpheniramine both increase sedation. Use Caution/Monitor.
- chlorpromazine
chlorpromazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Consider avoiding use of pseudoephedrine in patients receiving phenothiazines (especially thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. Monitor for evidence of ventricular arrhythmias during concomitant use.
acrivastine and chlorpromazine both increase sedation. Use Caution/Monitor. - chlorzoxazone
acrivastine and chlorzoxazone both increase sedation. Use Caution/Monitor.
- dexfenfluramine
dexfenfluramine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- clemastine
acrivastine and clemastine both increase sedation. Use Caution/Monitor.
- clobazam
acrivastine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).
acrivastine and clobazam both increase sedation. Use Caution/Monitor. - clomipramine
acrivastine and clomipramine both increase sedation. Use Caution/Monitor.
- clonazepam
acrivastine and clonazepam both increase sedation. Use Caution/Monitor.
- clonidine
acrivastine and clonidine both increase sedation. Use Caution/Monitor.
- clorazepate
acrivastine and clorazepate both increase sedation. Use Caution/Monitor.
- clozapine
acrivastine and clozapine both increase sedation. Use Caution/Monitor.
- cyclobenzaprine
acrivastine and cyclobenzaprine both increase sedation. Use Caution/Monitor.
- cyproheptadine
acrivastine and cyproheptadine both increase sedation. Use Caution/Monitor.
- dantrolene
acrivastine and dantrolene both increase sedation. Use Caution/Monitor.
- daridorexant
acrivastine and daridorexant both increase sedation. Use Caution/Monitor.
- desflurane
acrivastine and desflurane both increase sedation. Use Caution/Monitor.
- desipramine
acrivastine and desipramine both increase sedation. Use Caution/Monitor.
- dexbrompheniramine
acrivastine and dexbrompheniramine both increase sedation. Use Caution/Monitor.
- dexchlorpheniramine
acrivastine and dexchlorpheniramine both increase sedation. Use Caution/Monitor.
- dexmethylphenidate
dexmethylphenidate and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- dextroamphetamine
dextroamphetamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- diazepam
acrivastine and diazepam both increase sedation. Use Caution/Monitor.
- diethylpropion
diethylpropion and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- difenoxin hcl
acrivastine and difenoxin hcl both increase sedation. Use Caution/Monitor.
- dimenhydrinate
acrivastine and dimenhydrinate both increase sedation. Use Caution/Monitor.
- diphenhydramine
acrivastine and diphenhydramine both increase sedation. Use Caution/Monitor.
- diphenoxylate hcl
acrivastine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- dobutamine
dobutamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- dopamine
dopamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- dopexamine
dopexamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- doxazosin
pseudoephedrine decreases effects of doxazosin by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- doxepin
acrivastine and doxepin both increase sedation. Use Caution/Monitor.
- doxylamine
acrivastine and doxylamine both increase sedation. Use Caution/Monitor.
- droperidol
acrivastine and droperidol both increase sedation. Use Caution/Monitor.
- droxidopa
pseudoephedrine and droxidopa both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. May increase risk for supine hypertension
- efavirenz
acrivastine and efavirenz both increase sedation. Use Caution/Monitor.
- entacapone
acrivastine and entacapone both increase sedation. Use Caution/Monitor.
- ephedrine
ephedrine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
ephedrine, pseudoephedrine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. - epinephrine
epinephrine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- epinephrine inhaled
pseudoephedrine, epinephrine inhaled. Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- epinephrine racemic
epinephrine racemic and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- esketamine intranasal
esketamine intranasal, acrivastine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
esketamine intranasal, pseudoephedrine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .
acrivastine and esketamine intranasal both increase sedation. Use Caution/Monitor. - estazolam
acrivastine and estazolam both increase sedation. Use Caution/Monitor.
- fenfluramine
fenfluramine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- eszopiclone
acrivastine and eszopiclone both increase sedation. Use Caution/Monitor.
- ethanol
acrivastine and ethanol both increase sedation. Use Caution/Monitor.
- ethosuximide
acrivastine and ethosuximide both increase sedation. Use Caution/Monitor.
- ethotoin
acrivastine and ethotoin both increase sedation. Use Caution/Monitor.
- felbamate
acrivastine and felbamate both increase sedation. Use Caution/Monitor.
- fenfluramine
acrivastine and fenfluramine both increase sedation. Use Caution/Monitor.
- fexofenadine
acrivastine and fexofenadine both increase sedation. Use Caution/Monitor.
- flibanserin
acrivastine and flibanserin both increase sedation. Use Caution/Monitor.
- fluphenazine
acrivastine and fluphenazine both increase sedation. Use Caution/Monitor.
fluphenazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Consider avoiding use of pseudoephedrine in patients receiving phenothiazines (especially thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. Monitor for evidence of ventricular arrhythmias during concomitant use. - flurazepam
acrivastine and flurazepam both increase sedation. Use Caution/Monitor.
- formoterol
formoterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- gabapentin
acrivastine and gabapentin both increase sedation. Use Caution/Monitor.
- ganaxolone
acrivastine and ganaxolone both increase sedation. Use Caution/Monitor.
- guanfacine
acrivastine and guanfacine both increase sedation. Use Caution/Monitor.
- haloperidol
acrivastine and haloperidol both increase sedation. Use Caution/Monitor.
- hydralazine
hydralazine, pseudoephedrine. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Sympathomimetics can antagonize the activity of some antihypertensive agents.
- hydroxyzine
acrivastine and hydroxyzine both increase sedation. Use Caution/Monitor.
- iloperidone
acrivastine and iloperidone both increase sedation. Use Caution/Monitor.
- imipramine
acrivastine and imipramine both increase sedation. Use Caution/Monitor.
- insulin degludec
pseudoephedrine decreases effects of insulin degludec by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Sympathomimetics increase blood glucose by stimulating alpha and beta receptors; this action results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.
- insulin degludec/insulin aspart
pseudoephedrine decreases effects of insulin degludec/insulin aspart by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Sympathomimetics increase blood glucose by stimulating alpha and beta receptors; this action results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.
- insulin detemir
pseudoephedrine decreases effects of insulin detemir by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Sympathomimetics increase blood glucose by stimulating alpha and beta receptors; this action results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.
- insulin glargine
pseudoephedrine decreases effects of insulin glargine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Sympathomimetics increase blood glucose by stimulating alpha and beta receptors; this action results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.
- insulin inhaled
pseudoephedrine decreases effects of insulin inhaled by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Sympathomimetics increase blood glucose by stimulating alpha and beta receptors; this action results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.
- insulin regular human
pseudoephedrine decreases effects of insulin regular human by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Sympathomimetics increase blood glucose by stimulating alpha and beta receptors; this action results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.
- isoflurane
acrivastine and isoflurane both increase sedation. Use Caution/Monitor.
- isoproterenol
isoproterenol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- ketamine
acrivastine and ketamine both increase sedation. Use Caution/Monitor.
- ketotifen, drug-eluting contact lens
acrivastine and ketotifen, drug-eluting contact lens both increase sedation. Use Caution/Monitor.
- lamotrigine
acrivastine and lamotrigine both increase sedation. Use Caution/Monitor.
- lasmiditan
acrivastine and lasmiditan both increase sedation. Use Caution/Monitor.
- lemborexant
lemborexant, acrivastine. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects. .
acrivastine and lemborexant both increase sedation. Use Caution/Monitor. - levalbuterol
levalbuterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- levetiracetam
acrivastine and levetiracetam both increase sedation. Use Caution/Monitor.
- levocetirizine
acrivastine and levocetirizine both increase sedation. Use Caution/Monitor.
- levorphanol
acrivastine and levorphanol both increase sedation. Use Caution/Monitor.
- lisdexamfetamine
lisdexamfetamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- loratadine
acrivastine and loratadine both increase sedation. Use Caution/Monitor.
- lorazepam
acrivastine and lorazepam both increase sedation. Use Caution/Monitor.
- loxapine
acrivastine and loxapine both increase sedation. Use Caution/Monitor.
- lumateperone
acrivastine and lumateperone both increase sedation. Use Caution/Monitor.
- lurasidone
lurasidone, acrivastine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.
acrivastine and lurasidone both increase sedation. Use Caution/Monitor. - maprotiline
acrivastine and maprotiline both increase sedation. Use Caution/Monitor.
- meclizine
acrivastine and meclizine both increase sedation. Use Caution/Monitor.
- meperidine
acrivastine and meperidine both increase sedation. Use Caution/Monitor.
- meprobamate
acrivastine and meprobamate both increase sedation. Use Caution/Monitor.
- metaproterenol
metaproterenol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- metaxalone
acrivastine and metaxalone both increase sedation. Use Caution/Monitor.
- methamphetamine
methamphetamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- methenamine
methenamine decreases effects of pseudoephedrine by unknown mechanism. Use Caution/Monitor. Urinary excretion of indirect acting alpha/beta agonists (eg, pseudoephedrine) may increase when administered concomitantly with urinary acidifying agents, resulting in lower serum concentrations.
- methohexital
acrivastine and methohexital both increase sedation. Use Caution/Monitor.
- methsuximide
acrivastine and methsuximide both increase sedation. Use Caution/Monitor.
- methyldopa
methyldopa increases effects of pseudoephedrine by unknown mechanism. Use Caution/Monitor.
- methylenedioxymethamphetamine
methylenedioxymethamphetamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- midazolam
acrivastine and midazolam both increase sedation. Use Caution/Monitor.
- midazolam intranasal
midazolam intranasal, acrivastine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.
- midodrine
midodrine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- mirtazapine
acrivastine and mirtazapine both increase sedation. Use Caution/Monitor.
- molindone
acrivastine and molindone both increase sedation. Use Caution/Monitor.
- nalbuphine
acrivastine and nalbuphine both increase sedation. Use Caution/Monitor.
- nateglinide
pseudoephedrine decreases effects of nateglinide by pharmacodynamic antagonism. Use Caution/Monitor. Coadministration may reduce nateglinide's hypoglycemic action.
- nitrous oxide
acrivastine and nitrous oxide both increase sedation. Use Caution/Monitor.
- norepinephrine
norepinephrine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- nortriptyline
acrivastine and nortriptyline both increase sedation. Use Caution/Monitor.
- olanzapine
acrivastine and olanzapine both increase sedation. Use Caution/Monitor.
- oliceridine
acrivastine increases toxicity of oliceridine by Other (see comment). Use Caution/Monitor. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.
acrivastine and oliceridine both increase sedation. Use Caution/Monitor. - olodaterol inhaled
pseudoephedrine and olodaterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Caution with coadministration of adrenergic drugs by any route because of additive sympathetic effects
- olopatadine intranasal
acrivastine and olopatadine intranasal both increase sedation. Use Caution/Monitor.
- opicapone
acrivastine and opicapone both increase sedation. Use Caution/Monitor.
- opium tincture
acrivastine and opium tincture both increase sedation. Use Caution/Monitor.
- orphenadrine
acrivastine and orphenadrine both increase sedation. Use Caution/Monitor.
- oxazepam
acrivastine and oxazepam both increase sedation. Use Caution/Monitor.
- oxytocin
oxytocin increases effects of pseudoephedrine by pharmacodynamic synergism. Use Caution/Monitor.
- paliperidone
acrivastine and paliperidone both increase sedation. Use Caution/Monitor.
- pentazocine
acrivastine and pentazocine both increase sedation. Use Caution/Monitor.
- pentobarbital
acrivastine and pentobarbital both increase sedation. Use Caution/Monitor.
- perampanel
acrivastine and perampanel both increase sedation. Use Caution/Monitor.
- perphenazine
acrivastine and perphenazine both increase sedation. Use Caution/Monitor.
perphenazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Consider avoiding use of pseudoephedrine in patients receiving phenothiazines (especially thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. Monitor for evidence of ventricular arrhythmias during concomitant use. - phendimetrazine
phendimetrazine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- pheniramine
acrivastine and pheniramine both increase sedation. Use Caution/Monitor.
- phenobarbital
acrivastine and phenobarbital both increase sedation. Use Caution/Monitor.
- phentermine
phentermine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- phenylephrine
phenylephrine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- phenylephrine PO
phenylephrine PO and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- pimozide
acrivastine and pimozide both increase sedation. Use Caution/Monitor.
- pirbuterol
pirbuterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- pomalidomide
acrivastine and pomalidomide both increase sedation. Use Caution/Monitor.
- potassium phosphate
potassium phosphate decreases effects of pseudoephedrine by unknown mechanism. Use Caution/Monitor. Urinary excretion of indirect acting alpha/beta agonists (eg, pseudoephedrine) may increase when administered concomitantly with urinary acidifying agents, resulting in lower serum concentrations.
- pregabalin
acrivastine and pregabalin both increase sedation. Use Caution/Monitor.
- primidone
acrivastine and primidone both increase sedation. Use Caution/Monitor.
- prochlorperazine
acrivastine and prochlorperazine both increase sedation. Use Caution/Monitor.
prochlorperazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Consider avoiding use of pseudoephedrine in patients receiving phenothiazines (especially thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. Monitor for evidence of ventricular arrhythmias during concomitant use. - promazine
promazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.
- promethazine
acrivastine and promethazine both increase sedation. Use Caution/Monitor.
- promethazine
promethazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.
- propofol
acrivastine and propofol both increase sedation. Use Caution/Monitor.
- propylhexedrine
propylhexedrine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- protriptyline
acrivastine and protriptyline both increase sedation. Use Caution/Monitor.
- pyrilamine
acrivastine and pyrilamine both increase sedation. Use Caution/Monitor.
- quazepam
acrivastine and quazepam both increase sedation. Use Caution/Monitor.
- quetiapine
acrivastine and quetiapine both increase sedation. Use Caution/Monitor.
- ramelteon
acrivastine and ramelteon both increase sedation. Use Caution/Monitor.
- remifentanil
acrivastine and remifentanil both increase sedation. Use Caution/Monitor.
- remimazolam
acrivastine and remimazolam both increase sedation. Use Caution/Monitor.
- reserpine
acrivastine and reserpine both increase sedation. Use Caution/Monitor.
- risperidone
acrivastine and risperidone both increase sedation. Use Caution/Monitor.
- safinamide
pseudoephedrine and safinamide both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Monitor patients for hypertension if safinamide is prescribed concomitantly with prescription or nonprescription sympathomimetics, including nasal, oral, or ophthalmic decongestants and cold remedies.
- salmeterol
salmeterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- scopolamine
acrivastine and scopolamine both increase sedation. Use Caution/Monitor.
- serdexmethylphenidate/dexmethylphenidate
serdexmethylphenidate/dexmethylphenidate and pseudoephedrine both decrease sedation. Use Caution/Monitor.
serdexmethylphenidate/dexmethylphenidate and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - sevoflurane
acrivastine and sevoflurane both increase sedation. Use Caution/Monitor.
- silodosin
pseudoephedrine decreases effects of silodosin by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- sodium bicarbonate
sodium bicarbonate will increase the level or effect of pseudoephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor. Caution advised with frequent or high dose antacids
- sodium citrate/citric acid
sodium citrate/citric acid will increase the level or effect of pseudoephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- sodium lactate
sodium lactate will increase the level or effect of pseudoephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- sodium oxybate
acrivastine and sodium oxybate both increase sedation. Use Caution/Monitor.
- sodium phosphates, IV
sodium phosphates, IV decreases effects of pseudoephedrine by unknown mechanism. Use Caution/Monitor. Urinary excretion of indirect acting alpha/beta agonists (eg, pseudoephedrine) may increase when administered concomitantly with urinary acidifying agents, resulting in lower serum concentrations.
- solriamfetol
pseudoephedrine and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- spironolactone
spironolactone decreases effects of pseudoephedrine by pharmacodynamic antagonism. Use Caution/Monitor.
- stiripentol
stiripentol, acrivastine. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.
acrivastine and stiripentol both increase sedation. Use Caution/Monitor. - sufentanil
acrivastine and sufentanil both increase sedation. Use Caution/Monitor.
- sufentanil SL
acrivastine and sufentanil SL both increase sedation. Use Caution/Monitor.
- suvorexant
acrivastine and suvorexant both increase sedation. Use Caution/Monitor.
- tamsulosin
pseudoephedrine decreases effects of tamsulosin by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- tapentadol
acrivastine and tapentadol both increase sedation. Use Caution/Monitor.
- tasimelteon
acrivastine and tasimelteon both increase sedation. Use Caution/Monitor.
- temazepam
acrivastine and temazepam both increase sedation. Use Caution/Monitor.
- terazosin
pseudoephedrine decreases effects of terazosin by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- terbutaline
terbutaline and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- tetrabenazine
acrivastine and tetrabenazine both increase sedation. Use Caution/Monitor.
- thioridazine
acrivastine and thioridazine both increase sedation. Use Caution/Monitor.
thioridazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Consider avoiding use of pseudoephedrine in patients receiving phenothiazines (especially thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. Monitor for evidence of ventricular arrhythmias during concomitant use. - thiothixene
acrivastine and thiothixene both increase sedation. Use Caution/Monitor.
- trifluoperazine
trifluoperazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Consider avoiding use of pseudoephedrine in patients receiving phenothiazines (especially thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. Monitor for evidence of ventricular arrhythmias during concomitant use.
- tiagabine
acrivastine and tiagabine both increase sedation. Use Caution/Monitor.
- tizanidine
acrivastine and tizanidine both increase sedation. Use Caution/Monitor.
- tolcapone
acrivastine and tolcapone both increase sedation. Use Caution/Monitor.
- topiramate
acrivastine and topiramate both increase sedation. Use Caution/Monitor.
- trazodone
acrivastine and trazodone both increase sedation. Use Caution/Monitor.
- trifluoperazine
acrivastine and trifluoperazine both increase sedation. Use Caution/Monitor.
- triprolidine
acrivastine and triprolidine both increase sedation. Use Caution/Monitor.
- valproic acid
acrivastine and valproic acid both increase sedation. Use Caution/Monitor.
- vigabatrin
acrivastine and vigabatrin both increase sedation. Use Caution/Monitor.
- xylometazoline
pseudoephedrine and xylometazoline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- zaleplon
acrivastine and zaleplon both increase sedation. Use Caution/Monitor.
Minor (1)
- desmopressin
desmopressin increases effects of pseudoephedrine by pharmacodynamic synergism. Minor/Significance Unknown.
Adverse Effects
1-10%
Somnolence
Nervousness
Insomnia
Dry mouth
<1%
Headache
Dizziness
Asthenia
Nausea
Dyspepsia
Pharyngitis
Cough increase
Dysmenorrhea
Postmarketing Reports
Rare serious hypersensitivity reactions manifested by anaphylaxis, angioedema, bronchospasm, and erythema multiforme
Pseudoephedrine
- Tachycardia
- Palpitations
- Serious skin reactions (acute generalized exanthematous pustulosis)
Warnings
Contraindications
Hypersensitivity to acrivastine or other alkylamine antihistamines
Hypersensitivity to pseudoephedrine or other sympathomimetic amines
Severe hypertension
Severe coronary artery disease
Patients taking monoamine oxidase (MAO) inhibitors and for 14 days after stopping use of an MAO inhibitor
Cautions
Due to potential for sedation, assess individual responses before engaging in any activity requiring mental alertness, such as driving a motor vehicle or operating machinery
Concurrent use with alcohol or other CNS depressants may cause additional reductions in alertness and impairment of CNS performance and should be avoided
Not adequately studied for relieving common cold symptoms
Pregnancy & Lactation
Pregnancy Category: B
Lactation: Unknown whether acrivastine is distributed in breast milk, caution advised ; pseudoephedrine is excreted in human milk, caution advised
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Acrivastine exhibits H1-antihistaminic receptor activity, which prevents histamine from binding to its receptor in target cells
Pseudoephedrine: Indirect sympathomimetic agent, releases norepinephrine from adrenergic nerves
Half-Life
Acrivastine 1.9-3.5 hr; propionic acid metabolite 3.8 hrs
Pseudoephedrine 5-8 hr
Absorption
Rapid and complete
Vd
Acrivastine 0.46 L/kg
Pseudoephedrine 3 L/kg
Peak Plasma Time
Acrivastine 1.1 hr
Pseudoephedrine 1.97 hr
Peak Plasma Concentration
Acrivastine 227 ng/ml
Pseudoephedrine 422 ng/ml
Protein Bound
Acrivastine 50%
Pseudoephedrine minimal
Metabolism
Acrivastine 11% to propionic acid metabolite
Clearance
Acrivastine 2.9 mL/min/kg
Pseudoephedrine 5.9 mL/min/kg
Excretion
Acrivastine: feces (13%) urine (84%)
Pseudoephedrine: 55-75% renal (dependent on urine pH)
Images
Formulary
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