Hypersensitivity

mrsD · 02-17-2012, 10:37 AM

Yes, I like that drug checker too.

If anything it gives lots of moderate interactions.

Cardizem, as a hint, is a common interactor too.

Quinidine, cimetidine, coumadin, digoxin, carbamazepine are often tested against in drug applications today. So their inserts list interactions with them.

But those are not by far the only problematic ones. Cardizem is one. But the liver enzyme information is huge today compared to only years ago. Most doctors don't consult it at all IMO.
They wait for the pharmacy to catch it. And many pharmacists just blow away and override the moderate interactions or yellow flags. There can be SO MANY of these a day, one cannot call all those doctors and service patients in the same day anymore. That is no excuse, but there are SO MANY flags these days..you can't imagine.

bent98 · 02-17-2012, 01:44 PM

Quote:

Originally Posted by mrsD

Also quinidine is a main drug that interacts with others commonly.

Anyone on mixtures of RX products, would have to research it in depth to see if anything would interact (increasing drug levels of other common drugs).

Here is a good drug checker:
http://www.drugs.com/drug_interactions.html

The databases on these types of checkers, can always be out of date or not 100% inclusive.
So keep that in mind. The same is true of pharmacy data bases at your pharmacy.

You beat me to the punch MrsD. I always use that link. There is also one that does Canadan drugs that wont show up in that checker, like Domperidone. I cant seem to find the link but that one is the best.

en bloc · 02-17-2012, 02:38 PM

Quote:

Originally Posted by mrsD

Yes, I like that drug checker too.

If anything it gives lots of moderate interactions.

Cardizem, as a hint, is a common interactor too.

Quinidine, cimetidine, coumadin, digoxin, carbamazepine are often tested against in drug applications today. So their inserts list interactions with them.

But those are not by far the only problematic ones. Cardizem is one. But the liver enzyme information is huge today compared to only years ago. Most doctors don't consult it at all IMO.
They wait for the pharmacy to catch it. And many pharmacists just blow away and override the moderate interactions or yellow flags. There can be SO MANY of these a day, one cannot call all those doctors and service patients in the same day anymore. That is no excuse, but there are SO MANY flags these days..you can't imagine.

Yes, that Cardizem is a problematic one for sure. Last July had a similar reaction (fighting for excretion and compounding potency in the process) with Cardizem and Biaxin (for acute thrombophlebitis that got infected). I found out this combo is a huge no-no and never should have been prescribed. An ER doctor did it and later apologized after finding out what happened. The pharmacy did catch it and called the doctor before filling. Doctor didn't think it would be that bad and confirmed the order. What idiots!! It's like a huge overdose of Cardizem (and compounded with an OD of Ranexa in this last case). Very dangerous...life threatening, in fact. Luckily I have a pacemaker (it will dramatically drop the heart rate), but still had very severe symtpoms and barely stayed conscious.

I research all my meds but never could find a good interaction tool like this one. EVERYTHING will be run through it from now on.

Are all calcium-channel blockers (like Cardizem) this problematic?

en bloc · 02-17-2012, 02:44 PM

Quote:

Originally Posted by bent98

You beat me to the punch MrsD. I always use that link. There is also one that does Canadan drugs that wont show up in that checker, like Domperidone. I cant seem to find the link but that one is the best.

I'd be interested in seeing the one you're talking about since I take Domperidone for my gastroparesis. The US has no other motility drug other then Reglan, which caused immediate movement disorders.

Thanks

mrsD · 02-17-2012, 02:56 PM

Still looking for an international drug checker... but I found
this useful table for liver enzyme inducers and inhibitors:

http://medicine.iupui.edu/clinpharm/...icalTable.aspx

This monograph gives alot of information including interactions.
http://www.drugs.com/mmx/domperidone-maleate.html

bent98 · 02-17-2012, 03:04 PM

Quote:

Originally Posted by en bloc

I'd be interested in seeing the one you're talking about since I take Domperidone for my gastroparesis. The US has no other motility drug other then Reglan, which caused immediate movement disorders.

Thanks

I know Reglan is bad stuff. That drug causes Permanent twitches, spams. Once again safe and effective drug to treat motility is not approved by FDA. You should note Domperidone is on the QT list. I mentioned before I was taking amitriptyline and Domperidone at same time and I occasionally felt a weird heart sensation but all in all was ok.

I took domperidone for esophagus motility and not gastric and it helped. I don’t take it anymore. I can’t find that darn link.

en bloc · 02-17-2012, 04:01 PM

That liver enzyme chart answered my question about other calcium channel blockers being problematic also...YES, it appears so.

MrsD. Don't know if you can explain this in a way I can understand, but isn't the domperidone using the same pathway as the Cardizem? Quote from Drug.com: "the main metabolic pathway of domperidone is through CYP3A4"

If so, how does this work in conjunction with a medicine like Cardizem? Can they actually share the same pathway without a problem? I notice Domperidone lists some of the interactor meds as inhibitors (Macrolide antibiotics), but not any of the calcium channel blockers...so does that means they are sharing the pathway without reaction?

In other words, just because they share the same path, does it always mean there will be a problem?

mrsD · 02-17-2012, 04:09 PM

That chart is from 2009... so some new drugs will not be on it.

However, the categories of enzymes, are listed in new drug inserts and you can refer to the chart for that.

Cardizem (diltiazem) is a moderate inhibitor of that enzyme.
Meaning, more drug will be around than without it.
That means a dose may be up to 2 times too strong when used with Cardizem, or up to 50-80% slower to clear.

I am sure there are other charts on the net, but they are difficult to find. I just happened on this one today.

This is another one.
https://docs.google.com/viewer?a=v&q...Z9Bi-s_2jfhRng

To find them keyword "cytochrome p450 chart"

But you will find them all a bit different as this science is constantly changing.

This is another focusing on psyche drugs:
http://www.psychresidentonline.com/C...teractions.htm

januarybabe · 02-25-2012, 10:41 AM

I see CVS has an anti-itch lotion which is like Sarna brand name. It is fragrance free.

It does help a little. I don't even like to wear pants as my legs are so sensitive. I wear dresses but that is problem in the cold winter months. I find gaucho pants are more comfortable as the seams and material are not so close to body.

Idiopathic PN · 03-01-2012, 02:46 PM

Quote:

Originally Posted by mrsD

Just a suggestion....

I don't think Lidoderms work on the bottoms of the feet.

I'd put them on the insteps instead. That is where both major nerves enter the foot.

A 1/2 patch is enough for each foot.

Also to try:
1) 1/2 patch around the top of the ankle before the foot starts.
2) if you think your issues are ganglion centered, then putting over the affected ganglions over the spine is best. This numbs them at the source.

This link shows yellow nerves...
http://www.northcoastfootcare.com/pa...e-Anatomy.html

hit Ctrl + scroll wheel to enlarge. The 3rd photo (anterior) in the first array shows the main nerve coming down in the instep.

This link shows the nerves in the foot more clearly:
http://www.northcoastfootcare.com/pa...-the-Foot.html

This website is excellent for viewing the feet, anatomy and where the nerves are and go.

Most people see no effects from placement on the bottoms of the foot.

Some experimentation is necessary. For example I find some foot relief when I place a 1/2 Lidoderm behind my knee, on the thigh side of the bend. This hits the peroneal nerve that passes there to go down to the foot.

Thank you soooo much for this information. I happened to read it accidentally...
I am using Lidoderm Patch in both the bottom of my feet but I was wondering why its not giving me any relief. Now I know.... I will have to put it where you suggested and see if there is a relief.

Mrs. D, my neurologist told me during my last visit that my large fibers are normal. She recommended that I should get my skin biopsy because my case is definitely a small fiber neuropathy. She explained to me that there are some cases of autoimmune diseases or antibodies that cannot be detected in the bloodworks (my blood results are all normal), but may be detected in the skin biopsy.

How true is this?
Thank you.

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