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Videx EC and Zagam

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

Check result:

Videx EC <> Zagam

Relevance: 08.11.2023 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 sparfloxacin may decrease the effects of sparfloxacin. Sparfloxacin should be administered at least 4 hours before 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 sparfloxacin 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 20 healthy volunteers, administration of an antacid containing aluminum and magnesium hydroxide (Maalox 30 mL) 2 hours before and 2 hours after a single 400 mg dose of sparfloxacin reduced the mean peak plasma concentration (Cmax) of sparfloxacin by 29% and 13% and its area under the concentration-time curve (AUC) by 23% and 17%, respectively. Administration of the antacid 4 hours after sparfloxacin showed no significant effect. The pharmacokinetics of sparfloxacin 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 sparfloxacin by divalent and trivalent cations is less marked than with ciprofloxacin, enoxacin, or norfloxacin.

MANAGEMENT: Sparfloxacin should be administered at least 4 hours before 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

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
"Product Information. Zagam (sparfloxacin)." Rhone-Poulenc Rorer, Collegeville, PA.
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
"Product Information. Videx (didanosine)." Bristol-Myers Squibb, Princeton, NJ.
Johnson RD, Dorr MB, Talbot GH, Caille G "Effect of Maalox on the oral absorption of sparfloxacin." Clin Ther 20 (1998): 1149-58

Videx EC

Generic Name: didanosine

Brand name: Videx, Videx EC

Synonyms: n.a.

What is Videx EC?

Zagam

Generic Name: sparfloxacin

Brand name:

Synonyms: Zagam (Oral)

What is Zagam?

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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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