Drug interactions
Physostigmine + Umeclidinium
Severity: Moderate
Physostigmine and Umeclidinium: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Physostigmine inhibits cholinesterase and is used to reverse anticholinergic toxicity, so it would oppose the effects of umeclidinium. Its use is usually as an antidote, and it can itself cause bradycardia, bronchospasm and seizures.
What this interaction means in plain words
Physostigmine and Umeclidinium can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Pharmacodynamic antagonism between a cholinesterase inhibitor and a muscarinic antagonist.
What to do
Use physostigmine only for significant anticholinergic toxicity, with cardiac monitoring and atropine available. Watch for bronchospasm in patients with COPD.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Umeclidinium
- Tiotropium + Umeclidinium Major
- Aclidinium + Umeclidinium Moderate
- Atropine iv / + Umeclidinium Moderate
- Atropine + Umeclidinium Moderate
- Belladonna alkaloids + Umeclidinium Moderate
- Bethanechol + Umeclidinium Moderate
Frequently asked questions
Can I take Physostigmine with Umeclidinium?
MediHelp rates the interaction as moderate. Physostigmine and Umeclidinium can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Physostigmine inhibits cholinesterase and is used to reverse anticholinergic toxicity, so it would oppose the effects of umeclidinium. Its use is usually as an antidote, and it can itself cause bradycardia, bronchospasm and seizures.
How serious is the interaction between Physostigmine and Umeclidinium?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use physostigmine only for significant anticholinergic toxicity, with cardiac monitoring and atropine available. Watch for bronchospasm in patients with COPD.
What other medicines interact with Umeclidinium?
MediHelp also lists interactions of Umeclidinium with, for example, Tiotropium, Aclidinium, Atropine iv /. The full list is on the Umeclidinium page.
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