Drug General Information (ID: DDINSA9VQ0)
Drug Name			Doxepin (topical)		Drug Info		Potassium citrate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antidepressants				Minerals And Electrolytes
Structure

Mechanism of Doxepin (topical)-Potassium citrate Interaction (Severity Level: Major)
Increased risk of GI mucosal injury/bleeding risk Click to Show/Hide Mechanism Graph
Drug Name		Doxepin (topical)				Potassium citrate
Mechanism		Decrease gastrointestinal motility				GI mucosal injury/bleeding risk
Key Mechanism Factor 1
		Factor Name		Gastrointestinal toxicity
		Factor Description		The risk and severity of gastrointestinal toxicity, including inflammation, bleeding, ulceration, and perforation, increases when drugs with gastrointestinal mucosal irritant effects are combined.
Mechanism Description		Increased risk of GI mucosal injury/bleeding risk by the combination of Potassium citrate and Doxepin (topical)

Recommended Action
Management		The use of oral solid formulations of potassium citrate is considered contraindicated in patients receiving agents with anticholinergic properties at sufficient doses to exert anticholinergic effects. A liquid formulation of potassium citrate should be considered. Patients prescribed a solid oral formulation should be advised to discontinue potassium therapy and contact their physician if they experience potential symptoms of upper GI injury such as severe vomiting, abdominal pain, distention, and gastrointestinal bleeding.

References
1	McMahon FG, Ryan JR, Akdamar K, Ertan A "Upper gastrointestinal lesions after potassium chloride supplements: a controlled clinical trial." Lancet 2 (1982): 1059-61. [PMID: 6127542]
2	Product Information. K-Dur (potassium chloride). Schering Laboratories, Kenilworth, NJ.
3	Wynn V "Potassium chloride and bowel ulceration." Br Med J 5477 (1965): 1546. [PMID: 5850476]