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Nanny, so far I have located the following drug interactions from the above list:

Link:

http://www.drugstore.com/pharmacy/drugc ... &x=48&y=11

We found 12 interactions for:

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Cymbalta, Fexofenadine, Flexeril, Klonopin, Lisinopril, Methylene Blue, Methylin Er, Neurontin, Provigil, Soma, Trazodone, Testosterone, Ultram, Zanaflex (and food, alcohol, and tobacco)

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FLEXERIL (CYCLOBENZAPRINE HYDROCHLORIDE) and ULTRAM (TRAMADOL HYDROCHLORIDE)
Severity: Major

Description: Treatment with both cyclobenzaprine and tramadol may result in an increased risk of seizures.
Using cyclobenzaprine together with tramadol is usually not recommended, but may be required in some cases. If you are using both medicines together, your doctor may change the dose or how often you use one or both of the medicines. It is important to tell your doctor and pharmacist about all other medicines that you are using. Call your doctor if you feel confused, feel changes in mental awareness, have sudden muscle spasms, or have seizures. Do not stop using your medicines without talking to your doctor first.

KLONOPIN (CLONAZEPAM) and SOMA (CARISOPRODOL)
Severity: Major

Description: Taking a benzodiazepine and a centrally acting muscle relaxant may cause problems with your breathing.

Using benzodiazepine such as alprazolam, diazepam, or triazolam together with a centrally acting muscle relaxant such as dantrolene, methocarbamol, or chloroxazone is usually not recommended, but may be required in some cases. If you are using both medicines together, your doctor may change the dose or how often you use one or both of the medicines. It is important to tell your doctor and pharmacist about all other medicines that you are using. If you are already using a benzodiazepine and a centrally acting muscle relaxant, call your doctor if you have trouble breathing, have very slow breathing, feel short of breath, or have pale or blue lips, fingernails, or skin. Do not stop using your medicines without talking to your doctor first.

FLEXERIL (CYCLOBENZAPRINE HYDROCHLORIDE) and CYMBALTA (DULOXETINE HYDROCHLORIDE)
Severity: Major

Description: Treatment with both cyclobenzaprine and duloxetine may result in an increased risk of side effects.

Using cyclobenzaprine and duloxetine is usually not recommended but may be required in some cases. If you are using both medicines together, your doctor may change the dose or how often you use one or both of the medicines. It is important to tell your doctor and pharmacist about all other medicines that you are using. Call your doctor if you have a rapid or fast heart beat, feel unusually restless, have a fever, feel confused, are sweating, or have trouble moving your arms and legs. Do not stop using your medicines without talking to your doctor first.

ULTRAM (TRAMADOL HYDROCHLORIDE) and CYMBALTA (DULOXETINE HYDROCHLORIDE)
Severity: Major

Description: Treatment with both duloxetine and tramadol may result in an increased risk of side effects.

Using duloxetine together with tramadol is usually not recommended, but may be required in some cases. If you are using both medicines together, your doctor may change the dose or how often you use one or both of the medicines. It is important that you tell your doctor and pharmacist about all other medicines that you are using. Call your doctor if you have a rapid or fast heart beat, feel unusually restless, have a fever, feel confused, are sweating, or have trouble moving your arms and legs. Do not stop using your medicines without talking to your doctor first.

ULTRAM (TRAMADOL HYDROCHLORIDE) and ALCOHOL
Severity: Major

Description: Drinking alcohol (or taking any product containing alcohol) while being treated with tramadol may result in not being able to breathe as well or in slowing down your nervous system.

Drinking alcohol and using tramadol may cause serious side effects. Using tramadol and drinking alcohol should be avoided. It is important to tell your doctor and pharmacist about all other medicines that you are using and how much alcohol you drink. If you are already using tramadol and drinking alcohol, call your doctor if you feel short of breath, experience a loss of balance, slurred speech, confusion, changes in mental awareness or dizziness. Do not stop using your medicines without talking to your doctor first.

LISINOPRIL and ZANAFLEX (TIZANIDINE HYDROCHLORIDE)
Severity: Moderate

Description: Treatment with both lisinopril and tizanidine may result in low blood pressure.

Using lisinopril together with tizanidine may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If you are using both medicines together, your doctor may change the dose or how often you use one or both of the medicines. It is important to tell your doctor and pharmacist about all other medicines that you are using. Call your doctor if you feel lightheaded, feel dizzy, feel short of breath, or have a slow heartbeat. Do not stop using your medicines without talking to your doctor first.

ZANAFLEX (TIZANIDINE HYDROCHLORIDE) and ALCOHOL
Severity: Moderate

Description: Drinking alcohol (or any product containing alcohol) while being treated with tizanidine may result in an increased risk of side effects of tizanidine.

Using tizanidine and drinking alcohol is not recommended. It is important to tell your doctor and pharmacist about all other medicines that you are using and how much alcohol you drink. If you are already using tizanidine and drinking alcohol, call your doctor if you have muscle weakness or spasms, loss of balance or dizziness, have slurred speech, have changes in mental awareness, or have a dry mouth.

FEXOFENADINE (FEXOFENADINE HYDROCHLORIDE) and FOOD (GRAPEFRUIT JUICE)
Severity: Moderate

Description: Taking fexofenadine with grapefruit juice may result in less of fexofenadine in your blood, which may make the fexofenadine not work well for you.

Using fexofenadine and drinking grapefruit juice may cause your medicine to not work for you. Using fexofenadine and drinking grapefruit juice is not recommended. It is important to tell your doctor and pharmacist about all other medicines that you are using. Your doctor may want to monitor you more closely or order additional tests to determine how well your medicine is working. Do not stop using your medicines without talking to your doctor first.

FEXOFENADINE (FEXOFENADINE HYDROCHLORIDE) and FOOD (ORANGE JUICE)
Severity: Moderate

Description: Taking fexofenadine with orange juice may make the fexofenadine not work well for you.

Using fexofenadine and drinking orange juice may cause your medicine to not work for you. Using fexofenadine and drinking orange juice is not recommended. It is important to tell your doctor and pharmacist about all other medicines that you are using. If you are already using fexofenadine and drinking orange juice, call your doctor if you have itchy or watery eyes, have frequent sneezing, have a runny nose, or have generalized itching. Do not stop using your medicines without talking to your doctor first.

FEXOFENADINE (FEXOFENADINE HYDROCHLORIDE) and FOOD (APPLE JUICE)
Severity: Moderate

Description: Taking fexofenadine with apple juice may make the fexofenadine not work well for you.

Using fexofenadine and drinking apple juice may cause your medicine to not work for you. Using fexofenadine and drinking apple juice is not recommended. It is important to tell your doctor and pharmacist about all other medicines that you are using. Your doctor may want to monitor you more closely or order additional tests to determine how well your medicine is working. Do not stop using your medicines without talking to your doctor first.

TRAZODONE (TRAZODONE HYDROCHLORIDE) and FOOD
Severity: Minor

Description: Taking trazodone with food will help increase the amount of trazodone in your blood.

Taking trazodone with food will help your body absorb more of this medicine. It is recommended to take trazodone after a meal or light snack to get the best results from this medicine. It is important to tell your doctor and pharmacist about all other medicines that you are using. Do not stop using your medicines without talking to your doctor first.

KLONOPIN (CLONAZEPAM) and FOOD (CAFFEINE)
Severity: Minor

Description: Taking clonazepam with caffeine may result in clonazepam not working as well for you.

Using clonazepam and using caffeine may cause your medicine to not work for you. Using clonazepam and using caffeine is not recommended. Caffeine can be found in coffee, tea, soft drinks, and chocolate. It is important to tell your doctor and pharmacist about all other medicines that you are using. Your doctor may want to monitor you more closely or order additional tests to determine how well your medicine is working. Do not stop using your medicines without talking to your doctor first.





IMPORTANT: This tool doesn't include every possible interaction or account for individual responses to medicines. For example, very few studies examine how herbs, vitamins, and other supplements interact with medicines or each other. In addition, this tool doesn't list the increased effect you may experience when combining medicines with similar side effects. We recommend that you discuss this information with your doctor or pharmacist.



Severity rating definitions

What does "major" mean? The interaction may be life-threatening. Call your doctor immediately to discuss whether you should be taking these medicines together. Your doctor may need to change your therapy to reduce or prevent serious side effects.

What does "moderate" mean? The interaction may make your condition worse. Your doctor may need to change your therapy. Please talk to your doctor or pharmacist about using these medicines together.

What does "minor" mean? The interaction may increase the side effects of each drug. You can usually continue taking both drugs. If you experience any unusual or bothersome side effects, please report them to your doctor.


P.s. I would ask their pharmacist to suggest alternatives

avi123 wrote:I would be very careful withdrawing from SSRI. I been taking 10 mg of Paxil, which belongs to same family, for 2 decades , and can't withdraw easily from it.

Are you taking the paxil by choice or because it is so difficult to withdraw from?

I am always careful withdrawing from my medications. Well, except for the one time, when I wasn't. When I told my neurologist, she shook her head sadly and said, "You could die from doing that." So, now I am always careful.

Oh, yeah, and the three times my baclofen pump has malfunctioned. No slow withdrawal then, either. It was very sudden withdrawal. Definitely had a very high potential to be life threatening. Last time, in 2008, there was a period of days for which I have little to no memory. And then, someone shaking me, a loud voice... "Deborah! Deborah! Can you hear me?? I will take the restraint off if you PROMISE not to hit me. You have to promise, because I'm pregnant and I don't want you to hurt me. Can you PROMISE you won't hit me? Otherwise, I will have to leave the restraints on."

It was like waking up in someone else's nightmare...

I saw that nurse a few months back at a laundromat. She didn't recognize me until I said, "You made me promise not to hit you before you would take the restraints off." And then it call came back to her... She showed me the child she had been pregnant with at the time.

Deborah

avi123 wrote:

paper_nanny wrote:I was thinking that if my current medication regimine is causing serious sleep problems, I will have to find alternate medications which treat my symptoms as effectively, without adversly affecting my sleep

Well, this might take you years.

Yes, Avi, it might take me years. And that is a sad fact, one I have to consider every time I think about medication changes. Chronic incurable illness are just no fun. And that, too, is a sad fact, one I have to consider every time I consider how it is to be me.

Deborah

avi123 wrote: As to other drugs that are from the Benzodiazepine family such as Zolpidem, well, they were found to help with central apnea.

Zolpidem (Ambien) is not a benzo.

avi123 wrote: But overall, being a drug junkie causes acquiring a Central Sleep Apnea syndrome by its own.

No, it may cause or augment CompSAS. It also may not. There is insufficient data at this point to conclude that Paper_Nanny's central apneas are drug-induced. I'm also not sure what relevance "junkies" have to this thread. The fact that Paper_Nanny has many medical needs that require many prescriptions certainly does not put her in that category.

NotMuffy wrote:For instance, the point of the "what are you fixing"-- are you sleepy, have weakness, or are fatigued? I see like 6 "fatigues" up there, and xPAP does not fix fatigue, it fixes sleepy.

Yes, lots of fatigue. Fatigue is qualitatively different than sleepiness. I know that xPAP therapy will not fix fatigue and am not looking for it to do so. I am looking for it to fix the sleepy. During the first few weeks of BiPAP ASV treatment, the sleepy went away. It was incredible! The fatigue, however, was still there. Less of it, which makes sense because anytime there is a problem in the body- sickness, tired, dehydrateds- my ms symptoms, including the fatigue, get worse. When the problem is resolved, the symptoms, including fatigue, lessen. So, those first few weeks of BiPAP,less fatigue because there was less sleepy.

NotMuffy wrote:I have another question.

How long have you been using FitLife TFM?

Since 23 May 2011.

Paper_Nanny wrote:

NotMuffy wrote:I have another question.

How long have you been using FitLife TFM?

Since 23 May 2011.

Oh right, there it is.

I should have searched instead of watching "Matrix Reloaded".

J/K, Neo-phytes! Calm down already!

Anyway, as noted:

by Paper_Nanny on Wed Jun 08, 2011 10:32 pm

I looked at the graphs more carefully and I would actually say they look worse now that I have a mask with no major leakage issues.

There are 2 characteristics of masks that may have ramifications in xPAP breathing physiology.

• The volume of the mask. This can be individually calculated with a box of salt. This volume becomes a part of your respiratory physiology and needs to be accounted for as "Dead Space". Dead Space is air that is rebreathed and does not participate in ventilation. It is high in CO2.
• Calculated leak flow characteristics. Where the vent openings are located have a significant effect on the purge characteristics of the mask and CO2 washout. Consequently, a large deadspace effect may be negated by flow charteristics.
  
  Here's an example of that:
  
  
  
  If you have your mouth open with that mask, you could end up purging the oropharynx and actually reducing Vd.

That FitLife TFM looks like it has a huge Vd and inefficient purge characteristics.

Do you still have a Quattro floating around?

Another worthwhile investigation might be to see is the PTB stays consistent (at 100%) when using a mask with a smaller Vd. Perhaps machine sensitivity is affected.

For readers who may not have seen (on a "face") the two masks NotMuffy was discussing:

ResMed Quattro FX Full Face mask



Respironics FitLife Total Face mask


Interesting reading:
Dynamic dead space in face masks used with noninvasive ventilators: a lung model study
http://erj.ersjournals.com/content/23/1/129.full

Paper_Nanny wrote:

avi123 wrote:I would be very careful withdrawing from SSRI. I been taking 10 mg of Paxil, which belongs to same family, for 2 decades , and can't withdraw easily from it.

Are you taking the paxil by choice or because it is so difficult to withdraw from?

Deborah

Reply:


Nanny, this is a good question. I continue to take Paxil b/c I have difficulties to withdraw from it. I started to take Paxil 20 years ago when my Srink suggested that I do. He said that he himself takes Paxil to help deal with all the sh_t around him. So here I am stuck with it.

So far I have successfully withdrew from 10 mg of Zolpidem (generic Ambien) which helped me with starting CPAP 7 month ago. I did the vwithdrawal by replacing it with 0.5 mg, of Alprosalem (generic Xanax), 3 times daily.

Presently I started to withdraw from Paxil and Xanax.

Paxil withdrawal:

http://anxiety.emedtv.com/paxil/paxil-w ... ptoms.html

Xanax withdrawal:

http://anxiety.emedtv.com/xanax/xanax-withdrawal.html

Currently, I have no pain what so over, besides knee joints pain. I sleep 7 hours with one or two breaks to urinate. My Sleep Doc asked me, the other day, if I get up b/c I really need to urinate or b/c awakening from a sleep event? I replied that I am not sure. So he prescribed Flowmax which is used in men to treat the symptoms of an enlarged prostate (benign prostatic hyperplasia or BPH) which include difficulty urinating (hesitation, dribbling, weak stream, and incomplete bladder emptying), painful urination, and urinary frequency and urgency to control my bladder. So here I go with a new Rx again. Every new Doc that I see adds an Rx or two.

U.S. version of the dead space issue:


http://www.ncbi.nlm.nih.gov/pmc/article ... .6.539.pdf

avi123 wrote:U.S. version of the dead space issue:


http://www.ncbi.nlm.nih.gov/pmc/article ... .6.539.pdf

That is not "the" dead space issue, that is "a" dead space issue.

And to be more specific, it is not "this" dead space issue.

Is this my post? O yes, it's about the Static Dead Space. I found lot's of diff if I use a larger or smaller Static Dead Space:

Static Dead Spaces of CPAP masks in my collection:

Fisher & Paykel #431 and #432 FF , med size = 0ne cup = 8 oz = 250 ml
Respironics Comfort Gell Full, med size = same as above
Resmed Quattro FX, med size = 2/3 cup = 5.3 oz = 150 ml
Resmed Mirage Soft Gell, nasal, med size = ½ cup = 4 oz = 125 ml, vent holes are not in the mask

NotMuffy, I am sorry that I have not used salt to measure the inside volumes of the masks but plain faucet water instead.

NotMuffy wrote:

avi123 wrote:U.S. version of the dead space issue:


http://www.ncbi.nlm.nih.gov/pmc/article ... .6.539.pdf

That is not "the" dead space issue, that is "a" dead space issue.

And to be more specific, it is not "this" dead space issue.

OK, you are talking about the Dynamic Dead Space. If so do you change it just by the reorientation of the gaseous air flow?

avi123 wrote:

NotMuffy wrote:

avi123 wrote:U.S. version of the dead space issue:


http://www.ncbi.nlm.nih.gov/pmc/article ... .6.539.pdf

That is not "the" dead space issue, that is "a" dead space issue.

And to be more specific, it is not "this" dead space issue.

OK, you are talking about the Dynamic Dead Space. If so do you change it just by the reorientation of the gaseous air flow?

Excellent.

I think we've found Curly.

NotMuffy wrote:

avi123 wrote:OK, you are talking about the Dynamic Dead Space. If so do you change it just by the reorientation of the gaseous air flow?

Excellent.

I think we've found Curly.

And we don't need no Mo'.