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Maxaquin and Videx EC

Determining the interaction of Maxaquin and Videx EC and the possibility of their joint administration.

Check result:

Maxaquin <> Videx EC

Relevance: 19.09.2022 Reviewer: Shkutko P.M., M.D., in

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 didanosine together with lomefloxacin may decrease the effects of lomefloxacin. Lomefloxacin should be administered at least 2 hours before or 4 hours after didanosine. Contact your doctor if your infection worsens. If your doctor does prescribe 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:

ADJUST DOSING INTERVAL: Concomitant administration with didanosine buffered tablets or pediatric oral solution may reduce the oral bioavailability of lomefloxacin and other quinolone antibiotics. The mechanism is reduced quinolone absorption due to chelation with metallic cations from buffering agents and antacids used in certain formulations of didanosine. In 6 healthy volunteers, administration with an antacid containing aluminum hydroxide-magnesium oxide (800 mg-400 mg/2 g dose) reduced the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of a single 200 mg dose of lomefloxacin by 46% and 41%, respectively. The pharmacokinetics of lomefloxacin have not been studied in combination with the various didanosine formulations, but significant reductions in bioavailability have been reported for ciprofloxacin, another quinolone, in interaction studies with didanosine. There is some evidence, however, that chelation of lomefloxacin by divalent and trivalent cations is less marked than with ciprofloxacin, enoxacin, or norfloxacin.

MANAGEMENT: Lomefloxacin should be administered at least 2 hours before or 4 hours after didanosine buffered tablets or pediatric oral solution, and patients should be monitored for potentially decreased antimicrobial efficacy during concomitant therapy. Didanosine buffered powder for oral solution, which uses a citrate-phosphate buffer, and the delayed-release capsules, which are not buffered, are not expected to cause this interaction.

References

Shiba K, Sakamoto M, Nakazawa Y, Sakai O "Effects of antacid on absorption and excretion of new quinolones." Drugs 49(Suppl 2) (1995): 360-1
"Product Information. Videx (didanosine)." Bristol-Myers Squibb, Princeton, NJ.
Polk RE "Drug-drug interactions with ciprofloxacin and other fluoroquinolones." Am J Med 87 (1989): s76-81
Shimada J, Shiba K, Oguma T, et al "Effect of antacid on absorption of the quinolone lomefloxacin." Antimicrob Agents Chemother 36 (1992): 1219-24
Damle BD, Mummaneni V, Kaul S, Knupp C "Lack of Effect of Simultaneously Administered Didanosine Encapsulated Enteric Bead Formulation (Videx EC) on Oral Absorption of Indinavir, Ketoconazole, or Ciprofloxacin." Antimicrob Agents Chemother 46 (2002): 385-91
Deppermann KM, Lode H "Fluoroquinolones: interaction profile during enteral absorption." Drugs 45 Suppl 3 (1993): 65-72
Knupp CA, Barbhaiya RH "A multiple-dose pharmacokinetic interaction study between didanosine (videx(r)) and ciprofloxacin (cipro(r)) in male subjects seropositive for HIV but asymptomatic." Biopharm Drug Dispos 18 (1997): 65-77
Marchbanks CR "Drug-drug interactions with fluoroquinolones." Pharmacotherapy 13 (1993): s23-8
Mizuki Y, Fujiwara I, Yamaguchi T "Pharmacokinetic interactions related to the chemical structures of fluoroquinolones." J Antimicrob Chemother 37 Suppl A (1996): 41-55
Sahai J, Gallicano K, Oliveras L, Khaliq S, Hawley-Foss N, Garber G "Cations in the didanosine tablet reduce ciprofloxacin bioavailability." Clin Pharmacol Ther 53 (1993): 292-7

Maxaquin

Generic Name: lomefloxacin

Brand name:

Synonyms: n.a.

What is Maxaquin?

Videx EC

Generic Name: didanosine

Brand name: Videx, Videx EC

Synonyms: n.a.

What is Videx EC?

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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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