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Ofloxacin and Videx EC

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

Check result:

Ofloxacin <> Videx EC

Relevance: 07.11.2022 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 ofloxacin may decrease the effects of ofloxacin. Ofloxacin should be administered at least 2 hours before or 2 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 ofloxacin 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 14 healthy volunteers, administration of aluminum hydroxide-magnesium hydroxide (Maalox 15 mL) 2 hours before a single 400 mg dose of ofloxacin reduced the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of ofloxacin by 30% and 21%, respectively. Administration of the antacid 24 hours before and 2 hours after ofloxacin had no effect. Calcium carbonate (Titralac) also did not alter ofloxacin pharmacokinetics when dosing was separated by at least two hours. The pharmacokinetics of ofloxacin 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 ofloxacin by divalent and trivalent cations is less marked than with ciprofloxacin, enoxacin, or norfloxacin.

MANAGEMENT: Ofloxacin should be administered at least 2 hours before or 2 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

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
"Product Information. Videx (didanosine)." Bristol-Myers Squibb, Princeton, NJ.
Hoffken G, Lode H, Wiley R, et al "Pharmacokinetics and bioavailability of ciprofloxacin and ofloxacin: effect of food and antacid intake." Rev Infect Dis 10(Suppl) (1988): S138-9
"Product Information. Floxin (ofloxacin)." Ortho Pharmaceutical Corporation, Raritan, NJ.
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
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
Polk RE "Drug-drug interactions with ciprofloxacin and other fluoroquinolones." Am J Med 87 (1989): s76-81
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
Flor S, Guay DR, Opsahl JA, Tack K, Matzke GR "Effects of magnesium-aluminum hydroxide and calcium carbonate antacids on bioavailability of ofloxacin." Antimicrob Agents Chemother 34 (1990): 2436-8
Mizuki Y, Fujiwara I, Yamaguchi T "Pharmacokinetic interactions related to the chemical structures of fluoroquinolones." J Antimicrob Chemother 37 Suppl A (1996): 41-55
Marchbanks CR "Drug-drug interactions with fluoroquinolones." Pharmacotherapy 13 (1993): s23-8
Deppermann KM, Lode H "Fluoroquinolones: interaction profile during enteral absorption." Drugs 45 Suppl 3 (1993): 65-72
Akerele JO, Okhamafe AO "Influence of oral co-administered metallic drugs on ofloxacin pharmacokinetics." J Antimicrob Chemother 28 (1991): 87-94

Ofloxacin

Generic Name: ofloxacin

Brand name: Floxin, Floxin IV.

Synonyms: Ofloxacin (Systemic)

What is Ofloxacin?

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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