About us Contacts Drug interactions: 390 212
Drug search by name

Sodium picosulfate, magnesium, and citric acid and Zithromax (Azithromycin Oral Suspension)

Determining the interaction of Sodium picosulfate, magnesium, and citric acid and Zithromax (Azithromycin Oral Suspension) and the possibility of their joint administration.

Check result:
Sodium picosulfate, magnesium, and citric acid <> Zithromax (Azithromycin Oral Suspension)
Relevance: 17.07.2022 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:

The laxative effect of sodium picosulfate may be decreased when used during or following treatment with azithromycin. In addition, azithromycin can cause an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. The risk is increased if you have low blood levels of magnesium or potassium, which can occur with bowel cleansing preparations or excessive use of medications that have a laxative effect. Do not exceed the dose and duration of use of sodium picosulfate recommended on the product label or prescribed by your doctor. Alternatively, your doctor may prescribe a substitute for sodium picosulfate that is not affected by treatment with azithromycin. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications. In addition, you should let your doctor know if you experience signs and symptoms of low magnesium or potassium blood level such as weakness, tiredness, drowsiness, dizziness, confusion, tingling, numbness, muscle pain, cramps, nausea, or vomiting. 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:

GENERALLY AVOID: Theoretically, use of sodium picosulfate during or following antibiotic treatment may result in a reduced laxative effect of sodium picosulfate. The proposed mechanism involves antibiotic-induced reduction of colonic bacteria that hydrolyze sodium picosulfate, a prodrug, to its active metabolite bis-(p-hydroxyphenyl)-pyridyl-2-methane (BHPM), a compound that stimulates colonic peristalsis. The clinical significance of this effect remains unknown.

MONITOR: Bowel cleansing as well as overuse of certain laxatives may cause electrolyte loss and increase the risk of torsade de pointes ventricular arrhythmia in patients treated with drugs that prolong the QT interval. Electrolyte disturbances including hypokalemia and hypomagnesemia have been reported with laxative abuse and are known risk factors for torsade de pointes associated with QT interval prolongation.

MANAGEMENT: Consider use of an alternate laxative in patients who have recently taken or are currently taking an antibiotic. If concomitant use is required, additional bowel cleansing and colonoscopy may be required. The recommended dosage and duration of treatment with sodium picosulfate should not be exceeded. In addition, 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.

References
  • "MHRA. Medicines & Healthcare products Regulatory Agency (general site Reference) Available from: URL: http://www.mhra.gov.uk/spc-pil/index.htm."
  • "Product Information. Prepopik (citric acid/Mg oxide/Na picosulfate)." Ferring Pharmaceuticals Inc, Tarrytown, NY.
  • Chin RL "Laxative-induced hypokalemia." Ann Emerg Med 32 (1998): 517-8
  • Muller-Lissner SA "Adverse effects of laxatives: fact and fiction." Pharmacology 47 (1993): 138-45
  • Cerner Multum, Inc. "Canadian Product Information." O 0 (2015):
  • "Product Information. Clenpiq (citric acid/Mg oxide/Na picosulfate)." Ferring Pharmaceuticals Inc, Tarrytown, NY.
  • Canadian Pharmacists Association "e-CPS. Available from: URL: http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink."
  • Schaefer DC, Cheskin LJ "Constipation in the elderly." Am Fam Physician 58 (1998): 907-14
  • Cerner Multum, Inc. "Australian Product Information." O 0
  • Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Sodium picosulfate, magnesium, and citric acid

Generic Name: citric acid / magnesium oxide / sodium picosulfate

Brand name: Clenpiq, Prepopik

Synonyms: Citric acid, magnesium oxide, and sodium picosulfate

Zithromax (Azithromycin Oral Suspension)

Generic Name: azithromycin

Brand name: Zithromax, Zmax, AzaSite, Azithromycin 3 Day Dose Pack, Azithromycin 5 Day Dose Pack, Zithromax Tri-Pak, Zithromax Z-Pak, Zithromax IV

Synonyms: Zithromax

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.