Cipro Iv Minibags and Methadose Disp

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.

Ciprofloxacin may increase the blood levels and effects of methadone. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience increased side effects such as excessive drowsiness, tiredness, confusion, disorientation, nausea, vomiting, constipation, and shallow or difficult breathing. High blood levels of methadone can also occasionally cause an irregular heart rhythm that may be serious. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or fast or pounding heartbeats. 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.

MONITOR CLOSELY: Coadministration with ciprofloxacin may increase the plasma concentrations and pharmacologic effects of methadone. The proposed mechanism is ciprofloxacin inhibition of methadone metabolism via CYP450 3A4 and, to a lesser extent, CYP450 1A2. Respiratory depression as well as torsade de pointes arrhythmia have been reported. In one case report, a 42-year-old woman who had been on long-term methadone 140 mg/day for pain became sedated and confused two days following the addition of ciprofloxacin 750 mg twice a day for urosepsis. Ciprofloxacin was replaced with sulfamethoxazole-trimethoprim during hospitalization, and the patient recovered within 48 hours. The interaction was suspected on three subsequent occasions following reintroduction of ciprofloxacin by different prescribers, with the patient regaining her normal alertness each time after discontinuation of ciprofloxacin. However, during the last episode, the patient developed profound sedation and respiratory depression and required treatment with naloxone 0.4 mg intramuscularly. This apparent increase in severity of interaction coincided with a replacement of venlafaxine with fluoxetine, a potent CYP450 2D6 inhibitor, in her concomitant drug regimen. Since methadone is also partially metabolized by CYP450 2D6, the addition of fluoxetine may have further inhibited the clearance of methadone. In another case report, a patient who had been receiving methadone 120 mg/day developed syncope, QT prolongation, and torsade de pointes after self-medicating with his wife's ciprofloxacin. Concomitant risk factors reported include bradycardia and hypokalemia. The episode resolved after methadone was replaced with buprenorphine. Whether the interaction was primarily pharmacokinetic or pharmacodynamic is uncertain, since methadone levels were not measured. Methadone has been reported to cause dose-related prolongation of the QT interval, as has ciprofloxacin on rare occasions, thus additive pharmacodynamic effects cannot be ruled out.

MANAGEMENT: Caution is advised if methadone is prescribed in combination with ciprofloxacin. Pharmacologic response to methadone should be closely monitored and the dosage adjusted accordingly, particularly following initiation or discontinuation of ciprofloxacin in patients who are stabilized on their methadone regimen. It may be advisable to avoid using high dosages of methadone (>100 mg/day) with ciprofloxacin. In general, ECG monitoring should be considered for all methadone-treated patients with risk factors such as heart or liver disease; conduction abnormalities (e.g., congenital long QT syndrome; heart block); electrolyte disturbances (hypokalemia, hypomagnesemia); concomitant use of drugs that may cause QT prolongation or electrolyte loss; concomitant use of CYP450 3A4 inhibitors; or use of methadone at dosages greater than 100 mg daily. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope.

Cipro Iv Minibags

Generic Name: ciprofloxacin

Brand name: Cipro IV, Cipro, Cipro XR, Proquin XR

Synonyms: Cipro I.V. (injection)

What is Cipro Iv Minibags?

Methadose Disp

Generic Name: methadone

Brand name: Dolophine, Methadose, Methadose Sugar-Free, Diskets

Synonyms: Methadone

What is Methadose Disp?