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    Cardec DM

    Topic Contents

    Cardec DM

    Drug Information

    Cardec DM® is a combination drug containing carbinoxamine (an antihistamine similar to diphenhydramine ) plus pseudoephedrine and dextromethorphan. It is used to treat symptoms associated with the common cold and hay fever .

    Common brand names:

    Cardec DM, Histadec DM, Rondec-DM, Robitussin Cough & Allergy Liquid, Robitussin Pediatric Cough & Cold Nighttime Liquid

    Summary of Interactions with Vitamins, Herbs, & Foods

    Types of interactions: Beneficial Adverse Check

    Replenish Depleted Nutrients

    • none

    Reduce Side Effects

    • none

    Support Medicine

    • none

    Reduces Effectiveness

    • Green Tea

      Tannins are a group of unrelated chemicals that give plants an astringent taste. Herbs containing high amounts of tannins may interfere with the absorption of ephedrine or pseudoephedrine taken by mouth.1 Herbs containing high levels of tannins include green tea , black tea, uva ursi  (Arctostaphylos uva-ursi), black walnut (Juglans nigra), red raspberry  (Rubus idaeus), oak  (Quercus spp.), and witch hazel  (Hamamelis virginiana).

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
    • Oak

      Tannins are a group of unrelated chemicals that give plants an astringent taste. Herbs containing high amounts of tannins may interfere with the absorption of ephedrine or pseudoephedrine taken by mouth.2 Herbs containing high levels of tannins include green tea , black tea, uva ursi  (Arctostaphylos uva-ursi), black walnut (Juglans nigra), red raspberry  (Rubus idaeus), oak  (Quercus spp.), and witch hazel  (Hamamelis virginiana).

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
    • Teas and Herbs with Tannin

      Tannins are a group of unrelated chemicals that give plants an astringent taste. Herbs containing high amounts of tannins may interfere with the absorption of ephedrine or pseudoephedrine taken by mouth.3 Herbs containing high levels of tannins include green tea , black tea, uva ursi  (Arctostaphylos uva-ursi), black walnut (Juglans nigra), red raspberry  (Rubus idaeus), oak (Quercus spp.), and witch hazel  (Hamamelis virginiana).

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

    Potential Negative Interaction

    • Ephedra

      Ephedra is the plant from which ephedrine was originally isolated. Until 2004, ephedra-also called ma huang-was used in many herbal products including supplements promoted for weight loss . To prevent potentially serious interactions, people taking Cardec DM should avoid using ephedra-containing drug products and should read product labels carefully for ma huang or ephedra content. Native North American ephedra, sometimes called Mormon tea, contains no ephedrine.

    • Coleus

      A test tube study demonstrated that the bronchodilating effects of salbutamol, a drug with similar actions in the lung to ephedrine, were significantly increased by the addition of forskolin, the active component of the herb Coleus forskohlii. 5 The results of this preliminary research suggest that the combination of forskolin and beta-agonists (like ephedrine) might provide an alternative to raising the doses of the beta-agonist drugs as they lose effectiveness. Until more is known, coleus should not be combined with ephedrine without the supervision of a doctor.

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
    • Foods with Caffeine

      Caffeine, which is found in coffee, tea, chocolate, guaraná  (Paullinia cupana), and some nonprescription and supplement products, can amplify the side effects of ephedrine and pseudoephedrine. People should avoid combination products containing ephedrine/pseudoephedrine/ephedra and caffeine.

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

    Explanation Required 

    • Acidifying Foods

      Foods that acidify the urine may increase the elimination of ephedrine from the body, potentially reducing the action of the drug.6 Urine-acidifying foods include eggs, peanuts, meat, chicken, wheat-containing foods, and others.

      Foods that alkalinize the urine may slow the elimination of ephedrine from the body, potentially increasing the actions and side effects of the drug.7 Urine-alkalinizing foods include dairy products, nuts, vegetables (except corn and lentils), most fruits, and others.

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
    • Alkalinizing Foods

      Foods that alkalinize the urine may slow the elimination of ephedrine from the body, potentially increasing the actions and side effects of the drug.9 Urine-alkalinizing foods include dairy products, nuts, vegetables (except corn and lentils), most fruits, and others.

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
    The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers' package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

    References

    1. Brinker F. Interactions of pharmaceutical and botanical medicines. J Naturopathic Med 1997;7(2):14-20.

    2. Brinker F. Interactions of pharmaceutical and botanical medicines. J Naturopathic Med 1997;7(2):14-20.

    3. Brinker F. Interactions of pharmaceutical and botanical medicines. J Naturopathic Med 1997;7(2):14-20.

    4. Brinker F. Interactions of pharmaceutical and botanical medicines. J Naturopathic Med 1997;7(2):14-20.

    5. Yousif MH, Thulesius O. Forskolin reverses tachyphylaxis to the bronchodilator effects of salbutamol: an in-vitro study on isolated guinea-pig trachea. J Pharm Pharmacol 1999;51:181-6.

    6. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 105.

    7. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 105-6.

    8. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 105.

    9. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 105-6.

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