Drug General Information (ID: DDILEBYZ35)
Drug Name			Pseudoephedrine		Drug Info		Tromethamine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Decongestants				Genitourinary Tract Agents
Structure

Mechanism of Pseudoephedrine-Tromethamine Interaction (Severity Level: Moderate)
Altered urine pH Click to Show/Hide Mechanism Graph
Drug Name		Pseudoephedrine				Tromethamine
Mechanism		Urine pH sensitive				Urine alkalinizer
Key Mechanism Factor 1
		Factor Name		Urine pH
		Factor Description		The normal range of urine pH is between 4.5 and 8, depending mainly on the hydrogen ion concentration. Changes in urine pH may significantly affect drug reabsorption and excretion.
Mechanism Description		Altered elimination of Pseudoephedrine caused by Tromethamine mediated altered urine pH

Recommended Action
Management		Patients should be monitored for toxic effects such as tremor, anxiety, insomnia, irritability, or nervousness. Dosage reductions may be required.

References
1	Brater DC, Kaojarern S, Benet LZ, et al "Renal excretion of pseudoephedrine." Clin Pharmacol Ther 28 (1980): 690-4. [PMID: 7438686]
2	Kuntzman RG, Tsai I, Brand L, Mark LC "The influence of urinary pH on the plasma half-life of pseudoephedrine in man and dog and a sensitive assay for its determination in human plasma." Clin Pharmacol Ther 12 (1971): 62-7. [PMID: 5541135]
3	Wilkinson GR, Beckett AH "Absorption metabolism and excretion of the ephedrines in man. I. The influence of urinary pH and urine volume output." J Pharmacol Exp Ther 162 (1968): 139-47. [PMID: 5656593]