Combining propoxyphene with carbamazepine (Tegretol, Tegretol XR , Equetro, Carbatrol) may have severe effects on the brain including coma. Since propoxyphene causes constipation, the use of antidiarrheals, for example, diphenoxylate (Lomotil) and loperamide (Imodium), in persons taking propoxyphene can lead to severe constipation.
Drugs which both stimulate and block opioid receptors for example pentazocine (Talwin), nalbuphine (Nubain), butorphanol (Stadol), and buprenorphine (Buprenex), may reduce the effect of propoxyphene or may precipitate withdrawal symptoms from propoxyphene. Acetaminophen is metabolized (eliminated by conversion to other chemicals) by the liver. Therefore drugs that increase the action of liver enzymes that metabolize acetaminophen, for example, carbamazepine (Tegretol), isoniazid (INH, Nydrazid, Laniazid), and rifampin (Rifamate, Rifadin, Rimactane), reduce the levels of acetaminophen and therefore may decrease its action. Doses of acetaminophen greater than the recommended doses are toxic to the liver and may result in severe liver damage. The potential for acetaminophen to harm the liver is increased when it is combined with alcohol or drugs that also harm the liver.
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