Bupivacaine Comb.
Adverse Effect: decreased Comb Bupivacaine serum concentrations, decreased Comb. Bupivacaine effectiveness, enhanced anticholinergic effects (ileus, hyperpyrexia, sedation, dry mouth) .Clinical Management: Anticholinergics (benztropine, orphenadrine, procyclidine, trihexyphenidyl) should not be used routinely with phenothiazine derivatives as prophylaxis against possible extrapyramidal symptoms.
Cisapride
Adverse Effect: Loss of cisapride efficacy Clinical Management: The beneficial effects of cisapride are expected to be largely lost if an anticholinergic medication such as trihexyphenidyl is given concomitantly.
Fluphenazine
Adverse Effect: decreased phenothiazine serum concentrations, decreased phenothiazine effectiveness, and enhanced anticholinergic effects (ileus, hyperpyrexia, sedation, dry mouth) Clinical Management: Anticholinergics (benztropine, orphenadrine, procyclidine, trihexyphenidyl) should not be used routinely with phenothiazine derivatives as prophylaxis against possible extrapyramidal symptoms.
Haloperidol
Adverse Effect: excessive anticholinergic effects (sedation, constipation, dry mouth) Clinical Management: Use this combination only when clearly indicated. Monitor for excessive anticholinergic effects. Dosage adjustments may be required.
Procainamide
Adverse Effect: additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with Trihexiphenidyl
Thioridazine
Adverse Effect: decreased phenothiazine serum concentrations, decreased phenothiazine effectiveness, and enhanced anticholinergic effects (ileus, hyperpyrexia, sedation, dry mouth) Clinical Management: Anticholinergics (benztropine, orphenadrine, procyclidine, trihexyphenidyl) should not be used routinely with phenothiazine derivatives as prophylaxis against possible extrapyramidal symptoms.
Trifluoperazine
Adverse Effect: decreased Trifluoperazine serum concentrations, decreased Trifluoperazine effectiveness, and enhanced anticholinergic effects (ileus, hyperpyrexia, sedation, dry mouth) Clinical Management: Anticholinergics (benztropine, orphenadrine, procyclidine, trihexyphenidyl) should not be used routinely with Trifluoperazine derivatives as prophylaxis against possible extrapyramidal symptoms. |