Posted by ed_uk2010 on December 15, 2013, at 10:19:05
In reply to Re: Parnate help: drug interaction, posted by kirbyw on December 15, 2013, at 3:30:18
>From one of many websites regarding salbutamol which is also known as albuterol: What can I say?
Like Scott said, manufacturers are very keen to protect themselves by claiming that their medicines are safe with MAOIs. I looked into a possible interaction with salbutamol but you find virtually nothing apart from a case report of someone who experienced what appear to be normal side effects of salbutamol eg. tremor etc.
MAOIs interact with indirect-acting sympathomimetics such as ephedrine, phenylpropanolamine and pseudoephedrine because the combination leads to large amounts of sympathomimetic amines being released, which causes hypertension. MAOIs do not appear to interact with direct-acting selective beta-2 agonists, such as salbutamol and terbutaline. I checked a few sources. The UK BNF, which does not list an interaction. The UK product information for salbutamol and Parnate, which does not list an interaction. And I checked a specialist drug interactions textbook, which just lists the case report of someone who had 'side effects' after the combination, as mentioned above. Couldn't find anything online either, apart from vague warnings to avoid sympathomimetics, apparently written by people who do not realise there are different kinds of sympathomimetics. Salbutamol just seems to get lumped together with related drugs which do interact. Frankly, internet drug interaction checkers are often of very poor quality.
Just in case of potentiation, you'd want to start with one puff of the 100mcg salbutamol inhaler and then one more after about 10 minutes if needed. Doses can then by used every few hours, but only during attacks, salbutamol is not a good preventive. You may experience side effects, but they are unlikely to be severe unless you inhale too many doses. Salbutamol relieves bronchospasm eg. in asthma but will not relieve breathlessness causes by panic attacks - which may be aggravated.
If you have indeed developed asthma, a regular steroid inhaler should be used. Have you been tested for asthma?
In asthma (except severe chronic asthma), attacks of breathlessness and chest tightness are usually intermittent. They are sometimes brought on by exercise (normally in children) or things being sprayed into the air eg. perfumes.
Breathlessness in panic attacks in always intermittent.
Breathlessness in heart disease is usually quite long term but with exacerbations. It is worse on lying down, especially at night,
Breathlessness in COPD is always chronic, but with exacerbations brought on by infection.
poster:ed_uk2010
thread:1056037
URL: http://www.dr-bob.org/babble/20131209/msgs/1056216.html