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Moxifloxacin (Systemic) and Videx

Determining the interaction of Moxifloxacin (Systemic) and Videx and the possibility of their joint administration.

Check result:

Moxifloxacin (Systemic) <> Videx

Relevance: 08.07.2023 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 moxifloxacin may decrease the effects of moxifloxacin. Moxifloxacin should be administered at least 4 hours before or 8 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 moxifloxacin 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 12 healthy volunteers, administration of an antacid containing aluminum hydroxide-magnesium hydroxide (900 mg-600 mg/10 mL dose) 4 hours before, simultaneously, and 2 hours after a single 400 mg dose of moxifloxacin reduced the relative bioavailability of moxifloxacin by 23%, 60%, and 26%, respectively. The pharmacokinetics of moxifloxacin 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.

MANAGEMENT: Moxifloxacin should be administered at least 4 hours before or 8 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

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
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
Polk RE "Drug-drug interactions with ciprofloxacin and other fluoroquinolones." Am J Med 87 (1989): s76-81
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
Stass H, Bottcher MF, Ochmann K "Evaluation of the influence of antacids and H2 antagonists on the absorption of moxifloxacin after oral administration of a 400mg dose to healthy volunteers." Clin Pharmacokinet 40 Suppl 1 (2001): 39-48
"Product Information. Videx (didanosine)." Bristol-Myers Squibb, Princeton, NJ.
"Product Information. Avelox (moxifloxacin)" Bayer, West Haven, CT.
Deppermann KM, Lode H "Fluoroquinolones: interaction profile during enteral absorption." Drugs 45 Suppl 3 (1993): 65-72

Moxifloxacin (Systemic)

Generic Name: moxifloxacin

Brand name: Avelox, Avelox IV

Synonyms: Moxifloxacin

What is Moxifloxacin (Systemic)?

Videx

Generic Name: didanosine

Brand name: Videx, Videx EC

Synonyms: n.a.

What is Videx?

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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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