Drug Interactions19.docx

DRUG INTERACTIONS(7)

MONITOR CLOSELY: 

DOXORUBICIN + CYCLOPHOSPHAMIDE doxorubicin increases toxicity of cyclophosphamide by unspecified interaction mechanism. Use Caution/Monitor. Increased risk of hemorrhagic cystitis.

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DEXAMETHASONE + DOXORUBICIN dexamethasone will decrease the level or effect of doxorubicin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

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DEXAMETHASONE + ONDANSETRON dexamethasone will decrease the level or effect of ondansetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No dosage adjustment for ondansetron is recommended for patients on these drugs.

MINOR: 

DEXAMETHASONE + RABEPRAZOLE dexamethasone will decrease the level or effect of rabeprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

Reference: medcape.com.

DRUG INTERACTIONS(8)

MONITOR CLOSELY: 

APREPITANT + DEXAMETHASONE aprepitant will increase the level or effect of dexamethasone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

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DEXAMETHASONE + APREPITANT dexamethasone will decrease the level or effect of aprepitant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

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DEXAMETHASONE + ONDANSETRON dexamethasone will decrease the level or effect of ondansetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No dosage adjustment for ondansetron is recommended for patients on these drugs.

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LEUCOVORIN + FLUOROURACIL leucovorin increases toxicity of fluorouracil by pharmacodynamic synergism. Use Caution/Monitor.

MINOR: 

DEXAMETHASONE + RABEPRAZOLE dexamethasone will decrease the level or effect of rabeprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

Reference: medcape.com.

DRUG INTERACTIONS(Mt2)

MONITOR CLOSELY: DICLOFENAC + GENTAMICIN diclofenac increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

MINOR: 

METRONIDAZOLE + DICLOFENAC metronidazole will increase the level or effect of diclofenac by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

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DICLOFENAC + GENTAMICIN diclofenac increases levels of gentamicin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

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GENTAMICIN + CALCIUM CARBONATE gentamicin decreases levels of calcium carbonate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

Reference: medcape.com.

DRUG INTERACTIONS Mt8

MONITOR CLOSELY 

NIFEDIPINE + GENTAMICIN Nifedipine will decrease the level or effect of gentamicin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

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CALCIUM CARBONATE + NIFEDIPINE Calcium carbonate decreases effects of nifedipine by pharmacodynamic antagonism. Use Caution/Monitor.

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DICLOFENAC + GENTAMICIN Diclofenac increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

MINOR 

GENTAMICIN + THIAMINE Gentamicin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

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DICLOFENAC + GENTAMICIN Diclofenac increases levels of gentamicin by decreasing renal Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

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clearance.

GENTAMICIN + CALCIUM CARBONATE Gentamicin decreases levels of calcium carbonate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

Reference: medcape.com.

DRUG INTERACTIONS(c8) Serious - Use Alternative

Ciprofloxacin + Ondansetron Ciprofloxacin and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.

Minor Metronidazole + Amlodipine metronidazole will increase the level or effect of amlodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

Reference: medcape.com.

DRUG INTERACTIONS(c1) 

MONITOR CLOSELY: Chlordiazepoxide oral + Lorazepam oral Potential for interaction chlordiazepoxide oral and lorazepam oral both increase sedation and drowsiness

Reference: medcape.com.

DRUG INTERACTIONS(0r10) Serious 

aluminum-magnesium hydroxide oral + ciprofloxacin oral aluminum-magnesium hydroxide oral decreases levels of ciprofloxacin oral by reducing drug absorption from the stomach and intestine into the body when taken by mouth Additional Information: ,Take these drugs 2 hours apart.or alternate medication may be needed

Monitor closely 

aluminum-magnesium hydroxide oral + ciprofloxacin oral aluminum-magnesium hydroxide oral decreases levels of ciprofloxacin oral by reducing drug absorption from the stomach and intestine into the body when taken by mouth Additional Information: Should not be taken together; may reduce availability of drug. Take ciprofloxacin at least 2 hours before or 6 hours after using these products. Use alternatives if available.

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Calcium 500 oral + ciprofloxacin oral Calcium 500 oral decreases effects of ciprofloxacin oral by reducing drug absorption from the stomach and intestine into the body when taken by mouth Additional Information: Ciprofloxacin should be taken 2 hours before or 6 hours after calcium salts.

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telmisartan oral + diclofenac oral telmisartan oral , diclofenac oral . Either increases toxicity of the other by Other mechanism Additional Information: Combination may reduce kidney function, particularly in elderly or volume depleted individuals.

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ciprofloxacin oral + metformin oral ciprofloxacin oral increases effects of metformin oral by added drug effects

Additional Information: May increase or decrease blood sugar. Careful monitoring of blood glucose is recommended. Reference: medcape.com.

DRUG INTERACTIONS(GM2c555)

Minor 

metronidazole oral + acetaminophen oral Interaction is unlikely, minor, or nonsignificant metronidazole oral will increase the level or effect of acetaminophen oral by altering drug metabolism

Reference: medcape.com.