.
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.
Interactions with Herbs
Ephedra sinica (Ma
huang)
Ephedra is the plant from which ephedrine was originally isolated. Ephedra—also called
ma huang—is 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.
Tannin-containing herbs
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).
Interactions with Foods and Other Compounds
Alcohol
Drinking alcohol while taking carbinoxamine can result in enhanced side effects such as
drowsiness and dizziness.2 Consequently, people who are taking Cardec DM should
avoid drinking alcoholic beverages, especially when staying alert is necessary.
Food
Foods that acidify the urine may increase the elimination of ephedrine from the body,
potentially reducing the action of the drug.3 Urine-acidifying foods include eggs, peanuts, meat,
chicken, vitamin C (greater than 5 grams per day),
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.4 Urine-alkalinizing foods include dairy products, nuts, vegetables (except corn and lentils), most fruits, and others.
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.
Summary of Interactions for Cardec DM
| Depletion or interference | None known |
|---|---|
| Adverse interaction | Caffeine Ephedra |
| Side effect reduction/prevention | None known |
| Supportive interaction | None known |
| Reduced drug absorption/bioavailability | Tannin-containing herbs* such as green tea, black tea, uva ursi, black walnut, red raspberry, oak, and witch hazel |
| Other (see text) | Vitamin C |
For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
References:
1. Brinker F. Interactions of pharmaceutical and botanical medicines. J Naturopathic Med 1997;7(2):14–20.
2. Olin BR, ed. Respiratory Drugs, Antihistamines. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, 1993, 964–79.
3. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 105.
4. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 105–6.
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