10 Medications That May Cause Increased Urination

Maybe you’ve noticed that you’re rushing to the restroom lately. Or you’re waking up in the middle of the night to go. Perhaps you’re needing to take way more breaks at work to pee.

There are many potential causes of frequent urination. They include, but are not limited to, an increase in water intake, a urinary tract infection, or onset of a new disease such as diabetes, as the Mayo Clinic notes.

It’s worth asking yourself: “Have I started a new medication lately?”

That gotta-go impulse is a relatively common side effect of various drugs available over-the-counter and by prescription. “Many medications can lead to urinary retention and something we call ‘overflow incontinence,’ which is when the bladder is not able to contract and expel urine effectively, leaving urine in the bladder,” says Brooke D. Hudspeth, PharmD, an associate professor and the chief practice officer at the University of Kentucky College of Pharmacy in Lexington. Other meds may interfere with the function of the urethra and lead to leakage or cause the bladder to quickly fill up with urine and make you pee more frequently.

Whether you’re on diuretics (“water pills”) to reduce your blood pressure, a decongestant to clear your sinuses, or a mood-stabilizing medication for bipolar disorder, here are some common medications that may be causing you to urinate more.

1. Diuretics

The point of a diuretic is to increase urination. “All diuretics work to increase the excretion of water and sodium from the body through the kidneys,” explains Dr. Hudspeth. This is helpful in treating conditions such as high blood pressure, swelling, heart failure, and liver or kidney disorders, she says. But peeing more can disturb your sleep if you’re waking up multiple times to go to the bathroom. Hudspeth recommends asking your doctor if you can take diuretics earlier in the day to avoid cutting into your sleep.

RELATED: 8 Common Medications That May Cause Dehydration

2. Tricyclic Antidepressants

Peeing is normally a well-orchestrated process. When your bladder fills up (and is holding that urine) the urethra — the tube connected to the bladder that empties urine — needs to stay shut to keep it all in until you decide you’re ready to go to the bathroom, says Hudspeth. What’s more, your bladder has to be able to contract to expel the urine into the urethra. Tricyclic antidepressants may interfere with both processes, and lead to leakage, also called urinary incontinence.

3. Antihistamines

For some people, sneezes can cause a little urine to leak. But this may also be due to an antihistamine that you’re taking to control allergy symptoms. The most common offenders are Benadryl (diphenhydramine) and Chlor-Trimeton (chlorpheniramine), says Jason Varin, PharmD, an assistant professor at the University of Minnesota College of Pharmacy in Minneapolis. “The bladder is a smooth muscle that fills up with urine. When it reaches a certain level and is full, it sends signals to the brain that it’s time to urinate,” he explains. Trouble is, certain antihistamines can relax the bladder, blunting its ability to push out urine. In the end, there is still some urine left in your bladder, which means it will fill up again faster and send that “gotta pee” signal to your brain sooner.

RELATED: 10 Common Food and Medication Interactions to Avoid

4. Decongestants

The good thing about decongestants such as Sudafed (pseudoephedrine) and Suphedrine PE (phenylephrine) is that they temporarily quell nasal congestion by constricting blood vessels, ultimately lessening swelling. But that effect happens to other muscles, too, including the bladder’s sphincter, says Dr. Varin. “This is the on-off valve of the bladder, and these medications may make the bladder constrict so that it’s more difficult for urine to pass from the bladder,” he says. In people with male genitalia, “decongestants can also constrict the prostate, which surrounds the urethra, also making it more difficult to pass urine,” Varin adds.

5. Calcium Channel Blockers

Among older adults who went to the doctor because of incontinence, 60 percent were taking medications that had urinary symptoms as a side effect, per a previous study. Among the most common medications they were taking? Calcium channel blockers. This class of medication, used to treat hypertension, may cause the bladder to relax and affect its ability to empty properly, says Hudspeth.

RELATED: What Does Burning or Painful Urination (Dysuria) Mean?

6. Mood Stabilizers

Lithobid (lithium) is a mood-stabilizing medication used to treat bipolar disorder, notes the National Alliance on Mental Illness (NAMI). “For some individuals, lithium is the best treatment, considered a lifesaver for some, even though it has a host of likely side effects,” says Varin. One of those potential side effects is excessive urination and thirst, which may affect up to 70 percent of individuals who take lithium long term, per a paper published December 2016 in the International Journal of Bipolar Disorders. While this side effect may be annoying, it can also be dangerous if the dose you’re taking is too high. “Lithium doses that are too high for an individual can lead to changes in the kidney and to a form of diabetes that impacts the function of the kidneys,” explains Varin. That condition is called diabetes insipidus, which is not the same as type 1 or 2 diabetes. “Diabetes insipidus has to do with the kidney’s ability to regulate fluids and reabsorb water properly, resulting in an increased urination of mostly fluids. In turn, that creates what some describe as an endless thirst,” he says. It can cause electrolyte and fluid imbalances, so talk to your doctor if you have these side effects.

7. Antipsychotics

Versacloz, FazaClo, and Clozaril (clozapine) are antipsychotic medications that treat schizophrenia, and can be a particularly important medication for patients who have suicidal thoughts, according to the U.S. National Library of Medicine. Frequent urination is one possible side effect because it can cause diabetes insipidus, says Hudspeth. One of the main complications of diabetes insipidus is dehydration, which has symptoms including thirst, dry skin, fatigue, dizziness, confusion, and nausea, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Talk to your doctor if you’re on this medication and experience increased urination.

RELATED: 10 Ways to Keep Your Bladder Healthy and Happy

8. Some Medications for Type 2 Diabetes

The newer medications for type 2 diabetes, a class called sodium-glucose cotransporter-2 (SGLT2) inhibitors work by “increasing the amount of glucose or blood sugar your kidneys excrete and pass through urine, which takes fluid with it,” says Varin. Some good news: There was a concern that SGLT2 inhibitors would also increase the risk of urinary tract infection (one symptom of UTI is a persistent urge to urinate, per the Mayo Clinic), but newer research has failed to find that connection, suggests the February 2020 issue of Clinical Kidney Journal.

9. Alpha Blockers

Alpha blockers, such as Cardura (doxazosin), Minipress (prazosin), and Hytrin (terazosin), are another class of medications used to treat high blood pressure. They work by relaxing blood vessels to allow for adequate blood flow — but they may also relax the muscles of the urethra and cause urinary incontinence, says Hudspeth. According to the Mayo Clinic, these drugs are often used in combination with other blood pressure lowering drugs, such as diuretics, so there’s a chance that increased urination issues could be caused by one or both these medications.

RELATED: The Possible Benefits of Metformin for Type 2 Diabetes and Other Health Conditions

10. Opioids

Opioids are drugs that can be prescribed by doctors to treat pain, such as OxyContin (oxycodone) or Vicodin (hydrocodone), morphine, and methadone, according to the Centers for Disease Control and Prevention (CDC). These are highly addictive, and one in four people who are treated long-term with these drugs experience opioid addiction, says the CDC. Clearly, that is the chief concern. But a lesser side effect is urinary problems, according to an article published in January 2017 in the International Journal of Molecular Sciences. Opioids can impair your bladder’s ability to empty by interfering with proper bladder contraction. Your doctor may be able to prescribe other pain control medications if you’re experiencing side effects.

If you have any concerns about your medication or new onset of urinary changes, speak to a primary care provider for an evaluation and medical guidance.

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Urinary Tract and Kidney Warnings on Nonprescription Products

US Pharm. 2014;39(8):12-15. 

Pharmacists are in a unique position with regard to counseling about OTC products. They can explore the various warnings and precautions on a product’s label to help patients decide when a product is inappropriate and a physician should be consulted, a process called pharmacist-assisted self-care triage. Many nonprescription products carry warnings related to the urinary tract, and knowledge of those products and the rationale for the warnings can help pharmacists provide the highest level of care.

Prostate Warnings

An enlarged prostate is a fact of life for males, especially as they reach the age of 40 years and beyond; by the age of 80 years, at least 90% of men suffer from benign prostatic hyperplasia (BPH). ¹ Because of its location surrounding the urethra, an enlarged prostate usually inhibits urine flow.² Several classes of nonprescription products are contraindicated in men with BPH, because they contain alpha-adrenergic agonists and/or anticholinergics.

Alpha-adrenergic agents such as pseudoephedrine, phenylephrine, and ephedrine all act to increase sphincter strength at the neck of the bladder, inhibiting a patient’s ability to urinate.³ For this reason, most nonprescription medications with these ingredients warn against use if the patient has decreased urination due to an enlarged prostate. If the patient were to ignore the warnings and use the product anyway, it is possible that acute urinary retention could result, requiring emergency catheterization to relieve the distended bladder.⁴

Alpha-adrenergic agonists (i.e., sympathomimetics) are found in numerous products marketed for the common cold, flu symptoms, and sinus problems, as well as in single-entity oral nasal decongestant products (e. g., Sudafed, Sudafed PE), topical nasal decongestants (e.g., Afrin, Neo-Synephrine), asthma products (e.g., Primatene), hemorrhoid products (e.g., several Preparation H products), and some ophthalmic drops (e.g., Opcon-A, Naphcon-A, Visine-A).⁵

Nonprescription medications with anticholinergic effects could also inhibit bladder flow.⁶ The target group for this labeling includes the large number of products containing first-generation antihistamines, such as chlorpheniramine, clemastine, cyclizine, dimenhydrinate, diphenhydramine, doxylamine, meclizine, pheniramine, and pyrilamine. Some products containing them are safe and effective for treating allergic rhinitis and/or the common cold, such as Chlor-Trimeton, Tavist, and Benadryl. Others help relieve occasional insomnia (e.g., Nytol, Unisom). They are also the single ingredient in products for preventing and treating motion sickness (e.g., Dramamine, Bonine, Marezine) and are a component of ophthalmic vasoconstrictor/antihistamine drops (e. g., Opcon-A, Naphcon-A, Visine-A). They are also found in numerous combination products marketed for the common cold and related conditions. All of these products will carry the required prostate warning.⁵

Kidney Disease

A number of nonprescription products carry a vague warning against use if the patient has “kidney disease.” The spectrum of kidney disease is exceedingly broad, but the label was apparently kept nonspecific so that all patients with any type of kidney disease would be alerted to seek professional advice before using them.

Antacid product labels must display the kidney disease warning if they contain >50 mEq of magnesium or >25 mEq of potassium per maximum recommended daily dose. The warning is intended to prevent hypermagnesemia and hyperkalemia in patients with a reduced ability to eliminate these ions through urination. Such products include Maalox Advanced Regular Strength Liquid and Alka-Seltzer Gold.⁵

Certain histamine₂ (H₂)-blockers carry the kidney disease precaution, as they are primarily eliminated renally. ⁷ These include Pepcid AC Maximum Strength and Zantac 150.⁵ The lower-dose formulations of both of these products are not required to carry a kidney disease precaution.

Laxatives containing magnesium also carry a warning against use in patients with kidney disease. Like antacids, laxatives must carry a kidney disease warning if they contain >50 mEq of magnesium per maximum recommended daily dose. This would apply to Phillips’ Milk of Magnesia and magnesium citrate products such as Citroma. Another laxative with a kidney disease warning is polyethylene glycol (PEG) 3350 (e.g., MiraLAX). The concern is apparently that PEG might cause volume depletion.⁸

Oral analgesics may carry a warning against use with kidney disease. For the same reasons mentioned above (i.e., avoiding hypermagnesemia), the precaution is found on magnesium salicylate-containing analgesics, such as Doan’s Pain Reliever.⁵

One of the more inclusive labeling changes in regard to kidney disease was proposed by the FDA in a 2006 issue of the Federal Register and finalized in 2009. ^9,10 The FDA stated that it had received serious adverse event reports regarding nonsteroidal anti-inflammatory drugs (NSAIDs) and renal toxicity. The agency affirmed that most healthy people who ingest NSAIDs for a limited time tolerate them well.⁹ However, the FDA went on to list a group of patients who are predisposed to adverse renal effects when taking NSAIDs. The possible sequelae are life-threatening nephro-toxicity, such as acute renal failure and serious fluid and electrolyte disorders. Patients more prone to this adverse effect include those with volume depletion, underlying kidney disease, congestive heart failure, liver dysfunction with ascites, and the elderly. Furthermore, use during the last trimester of pregnancy can induce significant neonatal nephrotoxicity.

In further discussion, the FDA explored the link between NSAIDs and nephrotoxicity.^9,10 For instance, a decrease in renal production of vasodilatory prostaglandins would lead to acute reduction in blood flow and glomerular filtration. These changes would be expected to cause fluid retention, edema, and elevated serum creatinine. Thus, a pronounced decrease in renal perfusion could cause renal failure.

As a result of its exhaustive investigation of this issue, the FDA now requires the kidney disease warning on all products containing aspirin, magnesium salicylate, ibuprofen, naproxen, and ketoprofen.¹⁰

Second-generation antihistamines carry a warning against self-use with kidney disease. The products include loratadine (e.g., Claritin), cetirizine (e.g., Zyrtec), and fexofenadine (e.g., Allegra 24HR).⁵

Kidney Stones

As of this writing, the only non-prescription products to carry a specific warning against use with kidney stones are oxybutynin transdermal patches (Oxytrol for Women) and orlistat (alli). Orlistat can induce oxalate nephropathy

and resultant renal stone disease.¹¹ Oxalate nephropathy is characterized as a “rare but serious adverse effect” of orlistat directly due to an increase in fat malabsorption, which is the mechanism by which orlistat helps with weight loss. ¹²

Limited Fluid Intake Due to Renal Disease

Patients with renal failure or any other condition that requires them to limit fluid intake should be cautious in the use of fiber-replacement products such as psyllium (e.g., Metamucil) and methylcellulose (e.g., Citrucel).⁵

Oxybutynin Transdermal System

The most extensive set of warnings related to the urinary tract on any nonprescription product label is found on oxybutynin transdermal system (Oxytrol for Women).¹³ The product is indicated only for overactive bladder in women, characterized by two or more of the following (lasting for 3 months or more): urinary frequency more than 8 times in 24 hours, urinary urgency, and/or urge incontinence. The label warns prospective purchasers that frequent urination may also be caused by a urinary tract infection (UTI), diabetes, early pregnancy, and other more serious conditions, all of which require a physician appointment. The label also points out various symptoms of UTI, any of which would require an immediate physician appointment, including pain or burning when urinating (perhaps accompanied by fever or chills), blood in the urine, unexplained pain in the lower back or side, and/or urine that is cloudy or foul-smelling. ¹³

Women are advised not to use Oxytrol if they only experience accidental urine loss when they cough, sneeze, or laugh, as those are characteristic of stress incontinence, which will not be alleviated by the product. Patients who have urinary retention are cautioned not to use the product. The patch is not to be used if the patient has kidney stones. Patients are advised to stop use and make a physician appointment if they are not able to empty the bladder.¹³

Suggesting Alternative Approaches

The pharmacist can suggest alternative therapeutic approaches for patients with urinary tract contraindications in some cases. Nasal congestion may be relieved by nasal strips such as Breathe Right, as they are safe for those with urinary compromise. Redness of the eye may be treated with single-entity ophthalmic drops (e.g., Visine), which do not carry prostate warnings. Allergic conjunctivitis may be treated with a single-entity ophthalmic antihistamine, such as Zaditor, as it is also free of urinary tract precautions. ⁵

Nonprescription antihistamines all carry urinary tract warnings: against use in patients with prostatic enlargement in the case of first-generation products, and against use in kidney disease in the case of second-generation products. Patients with allergic rhinitis can be advised to try cromolyn nasal spray (NasalCrom) or triamcinolone acetonide nasal spray (Nasacort Allergy 24HR). Neither carries a warning concerning the urinary tract.⁵

In regard to gastric products, patients may try such antacid ingredients as calcium carbonate (e.g., Tums) or bismuth subsalicylate (e.g., Pepto-Bismol). They may also try the lower dose versions of Pepcid and Zantac, neither of which carries a urinary tract warning. Further, none of the four currently available proton pump inhibitors (e.g., Prilosec OTC, Prevacid 24HR, Zegerid OTC, Nexium 24HR) carries a urinary tract-related label precaution, and may be recommended for the patient with frequent heartburn, as defined on the label of those products. ⁵

Acetaminophen is free of urinary tract warnings, and may be preferable for the patient with kidney disease. However, as with all nonprescription product counseling sessions, pharmacists should point out the numerous additional warnings and situations in which acetaminophen is contraindicated, such as with liver disease.⁵

PATIENT INFORMATION

Prostate Problems

The prostate is a male organ that circles the urinary outflow channel leading from the bladder. As men age, a large percentage of them develop a condition known as benign prostatic hyperplasia, or enlargement of the prostate. An enlarged prostate slowly restricts bladder outflow, making it difficult to urinate. Some nonprescription products can make it even harder to urinate, and the patient who takes them without reading and following the label may need to visit an emergency room to be catheterized so the bladder can be emptied.

These patients should first speak to their physician so the doctor can judge whether they might be able to use such a product in their particular situation. Products of concern include nasal decongestants (e.g., pseudoephedrine, phenylephrine, naphazoline), as found in such dosage forms as tablets, oral liquids, nasal sprays, and nasal drops. Nasal decongestants are also popular ingredients in combination products for the common cold, allergic rhinitis, sinus problems, and flu symptoms.

Some antihistamines are also hard on the prostate. They are found in products for the common cold and allergic rhinitis, motion sickness products, sleep aids, and some eye drops. Ingredients of concern include doxylamine, clemastine, cyclizine, meclizine, chlorpheniramine, diphenhydramine, dimenhydrinate, and pheniramine.

If you do not have a physician who can be consulted, you should ask your pharmacist. Pharmacists can often suggest therapeutic alternatives that would be risk-free for those with prostate enlargement.

Kidney Disease

Some nonprescription products are eliminated from your body via your urine. They include some antacids (products containing magnesium and/or potassium), other stomach medications (some products containing ranitidine or famotidine), some laxatives (those containing magnesium), and certain antihistamines (loratadine, cetirizine, and fexofenadine). If your body’s ability to eliminate these medications is compromised by kidney disease, the drug levels in your blood can endanger your health. Your physician should be consulted to make a decision about possibly lowering the dose on the label so you will be safe. Once again, your pharmacist can help you with therapeutic alternatives that do not present problems with kidney disease, when they are available.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a type of pain medication that can cause kidney damage, especially if you already have kidney disease. Examples include aspirin, magnesium salicylate, ibuprofen, naproxen, and ketoprofen. It is best to avoid NSAIDs completely and speak to your physician or pharmacist about safer alternatives.

Kidney Stones

If you have kidney stones, you should avoid taking the OTC weight-loss product alli (due to an increase in fat malabsorption). You should also not use Oxytrol for Women, a patch product for overactive bladder in women, because it might possibly cause urinary retention.

Limited Fluid Intake Due to Renal Disease

Some patients have kidney damage that forces them to limit their fluid intake to prevent fluid overload. If you have this problem, you should avoid nonprescription products that must be taken with a lot of fluid so you can get them down. This includes bowel regulation products containing psyllium and methylcellulose. 

REFERENCES

1. Enlarged prostate. MedlinePlus. www.nlm.nih.gov/medlineplus/ency/article/000381.htm. Accessed June 20, 2014.

2. Prostate enlargement: benign prostatic hyperplasia. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement/. Accessed June 20, 2014.

3. Stress incontinence. MedlinePlus. www.nlm.nih.gov/medlineplus/ency/article/000891.htm. Accessed June 20, 2014.

4. Soyer T, Göl IH, Eroglu F, Cetin A. Acute urinary retention due to pseudoephedrine hydrochloride in a 3-year-old child. Turk J Pediatr. 2008;50(1):98-100.

5. Various products. www.drugstore.com. Accessed June 20, 2014.

6. Roehrborn CG. Acute urinary retention: risks and management. Rev Urol. 2005;7(suppl 4):S31-S41.

7. Ranitidine 150 mg. National Institutes of Health. http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=41453. Accessed June 20, 2014.8. Cohen LB, Kastenberg DM, Safdi AV. Current issues in clinical bowel preparation. Gastroenterol Hepatol. 2009;5(11 suppl 19):3-11.

9. FDA. Internal analgesic, antipyretic, and antirheumatic drug products for over-the-counter human use; proposed amendment of the tentative final monograph; required warnings and other labeling. Fed Regist. 2006;71(247):77314-77353.

10. FDA. Organ-specific warnings; internal analgesic, antipyretic, and antirheumatic drug products for over-the-counter human use; final monograph. Fed Regist. 2009;74(81):19385-19409.

11. Ahmed MH. Orlistat and calcium oxalate crystalluria: an association that needs consideration. Ren Fail. 2010;32(8):1019-1021.

12. Chaudhari D, Crisostomo C, Youngberg G. Acute oxalate nephropathy associated with orlistat: a case report with a review of the literature. Case Rep Nephrol. 2013;2013:124604. www.ncbi.nlm.nih.gov/pmc/articles/PMC3914170/. Accessed June 20, 2014.

13. Oxytrol for Women (oxybutynin transdermal system) package insert. Whitehouse Station, NJ: MSD Consumer Care, Inc; 2014.14. CDC. Prostate cancer. What are the symptoms? www.cdc.gov/cancer/prostate/basic_info/symptoms.htm. Accessed June 20, 2014.

15. Prostatitis—bacterial. MedlinePlus. www.nlm.nih.gov/medlineplus/ency/article/000519.htm. Accessed June 20, 2014.

To comment on this article, contact [email protected].

Benadryl Total/Allergy/Extra Strength (Acetaminophen, Diphenhydramine, Pseudoephedrine)
Page reviewed by pharmacist Kovalenko Svetlana Olegovna Cold and Flu Night Extra Strength (Acetaminophen,Diphenhydramine,Pseudoephedrine) Benylin Four FluFever `n Flu Night TimeSinutab NightimeBenylin All-in-One Cold and Flu Night Extra StrengthBenylin Day & Night (Acetaminophen,Diphenhydramine,Pseudoephedrine) Pseudoephedrine) Sinutab nightime (Acetaminophen, Diphenhydramine, PseudoEPHEDRINE) Benadryl Total/Extra Strengthbenadryl Total/Allergy/Extra Strena Strend gth (acetaminophen, diphenhydramine, pseudoephedrine) night and day n (acetaminophen, diphenhydramine, pseudoephedrine) night and day nfver `n Flu nightHht Time (Acetaminophen,Diphenhydramine,Pseudoephedrine)Boots 24 Hour Cold & Flu ReliefBoots Night Cold & Flu ReliefBoots Night Cold & Flu Relief (Acetaminophen,Diphenhydramine,Pholcodine,Pseudoephedrine)Boots 24 Hour Cold & Flu Relief (Acetaminophen,Diphenhydramine,Pholcodine,Pseud oephedrine)

Top 20 drugs with the same use:

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Drug name

Description Drug name Benadryl Total/Allergy/Extra Strength ( Acetaminophen,Diphenhydramine,Pseudoephedrine) is an automatic translation from the original language.
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Benadryl Total/Allergy/Extra Strength (Acetaminophen, Diphenhydramine, Pseudoephedrine)

Composition

Description udoephedrine) is an automatic translation from the language original.
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Diphenhydramine, Pseudoephedrine, Acetaminophen

Therapeutic Indications

Description Therapeutic Indications Benadryl Total/Allergy/Extra Strength (Acetaminophen,Diphenhydramine,Pseudoephedrine) is an automatic translation from the original language.
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For the relief of symptoms associated with colds and flu, including nasal congestion and congestion in the upper respiratory tract, sneezing, runny nose, cough, fever, headache, muscle aches and pains.

Dosage and Administration

Description Dosage and Administration Benadryl Total/Allergy/Extra Strength (Acetaminophen,Diphenhydramine,Pseudoephedrine) is an automatic translation from the original language.
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Oral

Adults, the elderly and children 16 years of age and older:

Two tablets, up to four times a day, as needed. Do not take more frequently than every four hours.

Children 10 to 15 years

One tablet, up to four times daily, as needed. Do not take more frequently than every four hours. Do not use for more than five days without consulting a doctor. Parents or guardians should seek medical attention if the child’s condition worsens during treatment.

Children under 10 years old

Benadryl Total/Allergy/Extra Strength Tablets (Acetaminophen, Diphenhydramine, Pseudoephedrine) are contraindicated in children under 10 years of age.

Do not exceed stated dose.

Contraindications

Description Contraindications Benadryl Total/Allergy/Extra Strength (Acetaminophen,Diphenhydramine,Pseudoephedrine) is an automatic translation from the original language.
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Hypersensitivity to diphenhydramine, paracetamol, pseudoephedrine or any of the excipients is known.

Concomitant use of other sympathomimetic drugs, including those administered by other routes, beta-blockers and monoamine oxidase inhibitors (MAOIs), or within 14 days after stopping treatment with MAOIs

Cardiovascular diseases, including hypertension

Diabetes mellitus

Feochrom cytoma

Hyperthyroidism

Angle-closure glaucoma

Severe renal failure

Do not use in children under 10 years of age.

Special Warnings and Precautions

Description Special Warnings and Precautions Benadryl Total/Allergy/Extra Strength (Acetaminophen,Diphenhydramine,Pseudoephedrine) is an automatic translation from the original language.
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Since both diphenhydramine and pseudoephedrine have been associated with central nervous system side effects, it is possible that the risk of such side effects may be increased with this combination.

If any of the following occurs, you should stop taking Benadryl Total/Allergy/Extra Strength Tablets (Acetaminophen, Diphenhydramine, Pseudoephedrine).

– Hallucinations

– Anxiety

– Sleep disorders

Use with caution in prostatic hypertrophy, urinary retention, tendency to angle-closure glaucoma, moderate renal failure, liver disease or occlusive vascular disease.

The risk of overdose is higher in persons with non-cirrhotic alcoholic liver disease.

The product may cause drowsiness. This product should not be used to soothe a child.

Product labeling will contain the following recommendations:-

In case of overdose, seek medical attention immediately, even if you feel well, because of the risk of delayed serious liver damage.

Do not take with any paracetamol containing products.

If symptoms persist, contact your doctor or pharmacist.

Keep out of the reach of children

Do not use to soothe a child.

Ask a doctor before use if you suffer from chronic or persistent cough, if you have asthma, are suffering from an acute asthma attack, or if the cough is accompanied by excessive secretions.

Effect on ability to drive and use machines

Description Effect on ability to drive and use machines Benadryl Total/Allergy/Extra Strength (Acetaminophen,Diphenhydramine,Pseudoephedrine) is an automatic translation from the original language.
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Benadryl Total/Allergy/Extra Strength (Acetaminophen, Diphenhydramine, Pseudoephedrine) may cause drowsiness. If patients are affected, they should not drive or use machinery.

Side Effects

Description Side Effects Benadryl Total/Allergy/Extra Strength (Acetaminophen,Diphenhydramine,Pseudoephedrine) is an automatic translation from the original language.
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Overdose

Description Overdose of Benadryl Total/Allergy/Extra Strength (Aceta minophen,Diphenhydramine,Pseudoephedrine) is an automatic translation from the original language.
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Paracetamol:

Liver damage is possible in adults who have taken 10 g or more of paracetamol. Ingestion of 5 g or more paracetamol may cause liver damage if the patient has risk factors (see

Risk factors:

If the patient

A. Is on long-term treatment with carbamazepine, phenobarbital, phenytoin, primidone, reef ampicin , St. John’s wort, or other drugs that induce liver enzymes.

Or

B. Regularly consumes ethanol in excess of recommended amounts.

Or

S. is likely to be depleted of glutathione, eg eating disorders, cystic fibrosis, HIV infection, starvation, cachexia.

Symptoms

Symptoms of paracetamol overdose in the first 24 hours are pallor, nausea, vomiting, anorexia and abdominal pain. Liver damage may appear 12-48 hours after ingestion. Possible violations of glucose metabolism and metabolic acidosis. In severe poisoning, liver failure can progress to encephalopathy, hemorrhage, hypoglycemia, cerebral edema, coma, and death. Acute renal failure with acute tubular necrosis, severe low back pain, hematuria, and proteinuria may develop even in the absence of severe liver damage. Cardiac arrhythmias and pancreatitis have been reported.

Management

Immediate treatment is necessary in the treatment of paracetamol overdose. Despite the absence of significant early symptoms, patients should be rushed to the hospital for immediate medical attention. Symptoms may be limited to nausea or vomiting and may not reflect the severity of the overdose or the risk of organ damage. Management should be in accordance with established treatment guidelines.

Treatment with activated charcoal should be considered if an overdose has been taken within 1 hour. Paracetamol plasma concentrations should be measured 4 hours or later after ingestion (earlier concentrations are unreliable). Treatment with N-acetylcysteine ​​can be used up to 24 hours after taking paracetamol, but the maximum protective effect is achieved up to 8 hours after taking it. After this time, the effectiveness of the antidote decreases sharply. If necessary, the patient should be given intravenous N-acetylcysteine ​​in accordance with the established dosing schedule. If vomiting is not a problem, oral methionine may be a suitable alternative for remote areas outside of the hospital. The management of patients with severe hepatic dysfunction after 24 hours of ingestion should be discussed with local centers and/or experts providing advice on poisons and overdose, or with the hepatic department.

Diphenhydramine:

Overdose symptoms may include drowsiness, hyperpyrexia and anticholinergic effects. At higher doses, especially in children, symptoms of CNS excitation include insomnia, nervousness, tremors, and epileptiform seizures. With a massive overdose, coma or cardiovascular collapse may occur.

Treatment of overdose should be symptomatic and supportive. Measures to promote gastric emptying (eg, induced emesis or gastric lavage) and, in cases of acute poisoning, activated charcoal may be helpful.

Pseudoephedrine:

As with other sympathomimetic drugs, symptoms of overdose include irritability, restlessness, tremors, convulsions, palpitations, hypertension, and difficulty urinating.

Necessary measures must be taken to maintain and maintain breathing and control convulsions. If necessary, gastric lavage should be carried out. Bladder catheterization may be required. If desired, elimination of pseudoephedrine can be accelerated by acid diuresis or dialysis.

Pharmacodynamics

Description Pharmacodynamics Benadryl Total/Allergy/Extra Strength (Acetaminophen,Diphenhydramine,Pseudoephedrine) is an automatic translation from the original language.
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ATX code: N02BE51. Diphenhydramine has a potent antihistamine effect, although most useful for influenza are its antitussive and, to a lesser extent, anticholinergic properties, which can alleviate mucus hypersecretion.

Paracetamol has a central analgesic and antipyretic effect, and pseudoephedrine is a mediated sympathomimetic with vasoconstrictive, bronchodilatory and anti-edematous effects.

Pharmacokinetics

Description Pharmacokinetics Benadryl Total/Allergy/Extra Strength (Acetaminophen,Diphenhydramine,Pseudoephedrine) is an automatic translation from the original language.
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Diphenhydramine is well absorbed after oral administration with peak plasma levels at 2.5 hours and is extensively metabolized on first pass. The drug is 75% bound to plasma proteins, but binding is reduced in chronic liver diseases. Metabolism occurs by 2 successive N-demethylations followed by oxidation to carboxylic acid. The terminal half-life is 3.4 to 9.3 hours.

Paracetamol is rapidly and completely absorbed with peak plasma levels occurring within 30-60 minutes. Less than 50% binds to protein, and the drug is evenly distributed throughout all body fluids. Paracetamol is eliminated by metabolism to inactive conjugates, followed by urinary excretion. The half-life is 2.75 – 3.25 hours.

Pseudoephedrine is rapidly absorbed, with peak serum levels at approximately 2.6 hours and onset of effect at approximately 30 minutes. It is well distributed in all body fluids and tissues. Approximately 50% of the drug is excreted unchanged, the rest is metabolized to inactive metabolites. About 6% is converted to the active metabolite norpseudoephedrine.

Preclinical Safety Data

Description Preclinical Safety Data Benadryl Total/Allergy/Extra Strength (Acetaminophen,Diphenhydramine,Pseudoephedrine) is an automatic translation from the original language.
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The active ingredients of Benadryl Total/Allergy/Extra Strength Tablets (Acetaminophen, Diphenhydramine, Pseudoephedrine) are well known pharmaceutical ingredients and their safety profile is well documented. The results of preclinical studies do not add anything significant for therapeutic purposes.

Interaction

Description Interaction Benadryl Total/Allergy/Extra Strength (Acetaminophen,Diphenhydramine,Pseudoephedrine) is an automatic translation from the original language.
Do not use this information for any medical prescription or manipulation under any circumstances.
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Unsuitable.

Special precautions for disposal and other handling

Description Special precautions for disposal and other handling
Do not use this information for any medical prescription or manipulation under any circumstances.
Be sure to read the original instructions for the medicine from the package.
This description may contain numerous errors due to automatic translation!
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No special requirements

Sources:

• https://www.drugs.com/mtm/allergy-relief-diphenhydramine-hcl.html
• https://pubmed.ncbi.nlm .nih.gov/?term=benadryl-total-allergy-extra-strength-acetaminophen-diphenhydramine-pseudoephedrine

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against allergies can lead to Alzheimer’s

Diana Tosepova

July 11, 15:36

During allergy season, many of us will turn to the first aid kit for relief. But antihistamines can negatively affect long-term health and even lead to dementia. Rambler will tell you more about this.

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Renowned doctor Alexander Myasnikov warned that antihistamines can trigger the development of Alzheimer’s disease.

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According to the specialist, the risk factors for this disease are genetic predisposition, lack of exercise, overweight, smoking and diabetes, and taking certain medications: benzodiazepines, opioids, and even antihistamines.

Scientists around the world have been talking about the harmful effects of antihistamines for years. A report published in the journal JAMA Internal Medicine highlights the link between long-term use of anticholinergic drugs such as Benadryl and dementia. We know that anticholinergics can cause confusion and increase the risk of falling in the elderly.

Anticholinergics block the action of acetylcholine. This substance transmits messages in the nervous system. In the brain, acetylcholine is involved in learning and memory. In other parts of the body, it stimulates muscle contractions. Anticholinergic drugs include some antihistamines, tricyclic antidepressants, overactive bladder control drugs, and drugs to relieve the symptoms of Parkinson’s disease.

A team led by Shelley Gray, a pharmacist at the University of Washington School of Pharmacy, tracked nearly 3,500 men and women aged 65 and over. Participants’ health was monitored for an average of seven years. During this time, 800 volunteers developed dementia. When researchers looked at the use of anticholinergic drugs, they found that people who took these drugs were more likely to develop dementia than those who did not. Moreover, the risk of dementia increased with cumulative dose. Taking anticholinergics for three years or more was associated with a 54% increased risk of dementia compared with taking the same dose for three months or less.

These studies are adding to the growing evidence that anticholinergics are not drugs that should be taken long-term if you want to keep a clear head in old age.

Foods to keep you safe from dementia

The body’s production of acetylcholine decreases with age, so blocking its effects can be a double whammy for older people.