Antibiotic Interactions: Keep away from for Secure Medicine
Antibiotic Interactions: Mixtures to Keep away from for Secure Medicine
1. Flucloxacillin
β-lactams are thought-about to be much less vulnerable to drug interactions. Flucloxacillin, nevertheless, might ⬇️ tacrolimus focus, presumably by means of enzyme induction
The identical can happen with flucloxacillin and broad-spectrum azoles (vori/posa) LINK
2. Pip-tazo
Pip-tazo can inhibit renal clearance of methotrexate (MTX) and ends in toxicity esp when excessive dose MTX is used (e.g. for haematological malignancy) LINK
3. Ciprofloxacin
Ciprofloxacin is a reasonable inhibitor of CYP1A2. Theophylline focus can improve 2-3 folds, leading to toxicity when concomitant cipro is used. LINK
4. Clarithromycin
Clarithromycin is a potent inhibitor of CYP3A4 and P-glycoprotein and may work together with many generally used medicine (e.g. Ca channel blocker, statin, antiepileptic)
It could be doubtlessly deadly when used with colchicine in renal failure LINK
5. TMPSMX
TMPSMX shouldn’t be given concomitantly with inhibitors of the renin-angiotensin system (ACEI/ARB) and aldosterone antagonists due to doubtlessly deadly hyper Okay that may happen quickly
Keep in mind, TMP acts like a Okay-sparing diuretic LINK
6. Carbapenems
Important discount (as much as 80%) in valproate degree can happen inside 24hrs of beginning carbapenems. Carbapenems⬇️valproate (VPA) degree by as much as ~80% inside 24hrs
How? Enzyme inhibition❗️
Inhibition of acetyl peptide hydrolase➡️ stops conversion of VPA-glucuronide again to lively VPA
⭐️Takes 7-14 days for decision
⭐️Elevating VPA dose is ❌helpful
⭐️Least impact with imipenem
