Drug General Information (ID: DDIDOY9Z73)
Drug Name			Dihydrocodeine		Drug Info		Mepenzolate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Narcotic Analgesics				Parasympatholytics
Structure

Mechanism of Dihydrocodeine-Mepenzolate Interaction (Severity Level: Moderate)
Additive antimotility effects Click to Show/Hide Mechanism Graph
Drug Name		Dihydrocodeine				Mepenzolate
Mechanism 1		Decrease gastrointestinal motility				Decrease gastrointestinal motility
Key Mechanism Factor 1
		Factor Name		Antimotility effects
		Factor Description		Antimotility drugs reduce bowel movements and increase contractions of intestinal segments for treatment of acute diarrhea. Excessive inhibition of intestinal motility can cause bloating and flatulence, increase abdominal cramps, and cause constipation at various times after treatment.
Mechanism Description		Additive antimotility effects by the combination of Dihydrocodeine and Mepenzolate
Additive CNS depression effects Click to Show/Hide Mechanism Graph
Drug Name		Dihydrocodeine				Mepenzolate
Mechanism 2		CNS depression effects				CNS depression effects
Key Mechanism Factor 2
		Factor Name		CNS depression effects
		Factor Description		CNS depressants are drugs that inhibit or suppress brain activity and can reduce mental and physical processes. Excessive CNS depression can lead to decreased heart rate, slow breathing (less than 10 breaths per minute), extreme confusion or loss of memory, nausea and vomiting, poor judgment, blue lips or fingertips, irritability and aggression, and clammy or cold skin.
Mechanism Description		Additive CNS depression effects by the combination of Dihydrocodeine and Mepenzolate

Recommended Action
Management		Caution and close monitoring of central nervous system, gastrointestinal, and genitourinary adverse effects are recommended when opioids are used with anticholinergic agents. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination.

References
1	Product Information. Exalgo (hydromorphone). Covidien, Mansfield, MA.
2	Product Information. Apadaz (acetaminophen-benzhydrocodone). KemPharm, Inc, Coralville, IA.
3	Product Information. Lortab (acetaminophen-hydrocodone). Akorn Inc, Buffalo Grove, IL.