Bismuth subcitrate potassium, metronidazole, and tetracycline and Gengraf
Determining the interaction of Bismuth subcitrate potassium, metronidazole, and tetracycline and Gengraf and the possibility of their joint administration.
In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.
Consumer:Using cycloSPORINE together with metroNIDAZOLE may increase the effects of cycloSPORINE. Contact your doctor if you experience nausea, vomiting, diarrhea, abdominal pain, dizziness, fatigue, headache, tremors, and convulsions. If your doctor prescribes these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Professional:MONITOR: Coadministration with a nitroimidazole may increase the blood concentrations of cyclosporine. The interaction has been reported with metronidazole, and the proposed mechanism is inhibition of hepatic cyclosporine metabolism via CYP450 3A4. In one case report, the cyclosporine levels of a kidney transplant patient increased more than 100% within 2 weeks after the addition of metronidazole (2.25 g/day) and cimetidine (800 mg/day). Levels declined when the metronidazole dosage was halved and the cimetidine stopped, and returned to their original levels when metronidazole was discontinued. In another report, a kidney transplant patient developed nephrotoxicity in association with a nearly 100% increase in cyclosporine levels following addition of metronidazole (1.5 g/day). No data are available for tinidazole.
MANAGEMENT: Caution is advised if cyclosporine is used with metronidazole. Cyclosporine blood levels and renal function should be checked frequently and the dosage adjusted accordingly, particularly following initiation or discontinuation of metronidazole therapy in patients who are stabilized on their cyclosporine regimen. Patients should be advised to notify their physician if they experience potential symptoms of cyclosporine toxicity such as nausea, vomiting, diarrhea, abdominal pain, dizziness, fatigue, headache, tremors, and convulsions. Given its structural similarities to metronidazole, the same precaution may be applicable during therapy with tinidazole, although clinical data are lacking.
- Zylber-Katz E, Rubinger D, Berlatzky Y "Cyclosporine interactions with metronidazole and cimetidine." Drug Intell Clin Pharm 22 (1988): 504-5
- "Product Information. Tindamax (tinidazole)." Presutti Laboratories Inc, Arlington Heights, IL.
- "Product Information. Flagyl (metronidazole)." Searle, Skokie, IL.
- Herzig K, Johnson DW "Marked elevation of blood cyclosporine and tacrolimus levels due to concurrent metronidazole therapy." Nephrol Dial Transplant 14 (1999): 521-3
Generic Name: bismuth subcitrate potassium / metronidazole / tetracycline
Brand name: Pylera
Synonyms: Bismuth Subcitrate, Metronidazole, and Tetracycline
Generic Name: cyclosporine
Brand name: Gengraf, Neoral, Sandimmune, Sandimmune
Synonyms: Gengraf (Capsules, Modified)
In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.
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