COMMON DRUG INTERACTIONS WITH FLOXACINES (QUINOLONE ANTIBIOTICS): 5-Fluro Quinolins (Commonly called Floxacins) (Pefloxacin, Ciprofloxacin, Norfloxacin, Ofloxacin, Levofloxacin, Gatifloxacin etc.) Antibiotics’ are commonly used to treat urinary tract infections. • The above are acidic drugs. • As a general pharmacological rule acidic drugs are stable in acidic medium and basic drugs are stable in basic medium. • Hence alkalization (PH more than 7) (Using Alkaline Citrate, Potassium Citrate etc) of urine results in decrease in the pharmacological activity.
COMMON DRUG INTERACTIONS WITH FLOXACINES (QUINOLONE ANTIBIOTICS): • Co-administration of probenecid does not affect serum concentrations of floxacines, but urinary excretion of the drug diminishes. • with other organic acid antibacterials, antagonism has been demonstratedin vitro between Floxacines and Nitrofurantoin. • Quinolones, , have been shown in vitro to inhibitCYP1A2. Concomitant use with drugs metabolised by CYP1A2 (e.g. caffeine,clozapine, ropinirole, tacrine, theophylline, tizanidine) may result in increased substrate drug concentrations when given in usual doses. Patients taking any of these drugs concomitantly with floxacines should be carefully monitored. • Elevated plasma levels of theophylline have been reported with concomitant quinolone use. There have been rare reports of theophylline-related adverse effects in patients on concomitant therapy with Floxacines and theophylline. Monitoring of theophylline plasma levels should be considered and dosage of theophylline adjusted as required. • Quinolones, , have also been shown to interfere with the metabolism of caffeine. This may lead to reduced clearance of caffeine and a prolongation of its plasma half-life. • Elevated serum levels of cyclosporin have been reported with concomitant use with floxacines, Cyclosporin serum levels should be monitored and appropriate cyclosporin dosage adjustments made when these medicines are used concomitantly. • Quinolones, may enhance the effects of oral anticoagulants including warfarin or its derivatives, Heparins (Low & High molecular heparins like Fondaparin, Enaxaparin etc) and Nicoumalone (Acitrom) or similar agents commonly used in cardiology and DVT. When these products are administered concomitantly, prothrombin time or other suitable coagulation tests should be closely monitored. • The concomitant administration of quinolones with Oral Hypoglycemic agents has, on rare occasions, resulted in severe hypoglycemia. Monitoring of blood glucose is recommended when these agents are co-administered. • Multivitamins, products containing iron or zinc, antacids or sucralfate should not be administered concomitantly with, or within 2 hours of, the administration of floxacines because they may interfere with absorption, resulting in lower serum and urine levels of Floxacines.. • Concomitant administration of a non-steroidal anti-inflammatory drug (NSAID) with quinolones, may increase the risk of stimulation of central nervous system and convulsive seizures. Floxacines should be used with caution in individuals receiving NSAIDs concomitantly. Animal data have shown that Quinolones in combination with NSAID’s can lead to convulsions. Concomitant administration of quinolones and NSAID’s should be avoided.
COMMON DRUG INTERACTIONS WITH FLOXACINES (QUINOLONE ANTIBIOTICS):
ReplyDelete5-Fluro Quinolins (Commonly called Floxacins) (Pefloxacin, Ciprofloxacin, Norfloxacin, Ofloxacin, Levofloxacin, Gatifloxacin etc.) Antibiotics’ are commonly used to treat urinary tract infections.
• The above are acidic drugs.
• As a general pharmacological rule acidic drugs are stable in acidic medium and basic drugs are stable in basic medium.
• Hence alkalization (PH more than 7) (Using Alkaline Citrate, Potassium Citrate etc) of urine results in decrease in the pharmacological activity.
COMMON DRUG INTERACTIONS WITH FLOXACINES (QUINOLONE ANTIBIOTICS):
ReplyDelete• Co-administration of probenecid does not affect serum concentrations of floxacines, but urinary excretion of the drug diminishes.
• with other organic acid antibacterials, antagonism has been demonstratedin vitro between Floxacines and Nitrofurantoin.
• Quinolones, , have been shown in vitro to inhibitCYP1A2. Concomitant use with drugs metabolised by CYP1A2 (e.g. caffeine,clozapine, ropinirole, tacrine, theophylline, tizanidine) may result in increased substrate drug concentrations when given in usual doses. Patients taking any of these drugs concomitantly with floxacines should be carefully monitored.
• Elevated plasma levels of theophylline have been reported with concomitant
quinolone use. There have been rare reports of theophylline-related adverse
effects in patients on concomitant therapy with Floxacines and theophylline.
Monitoring of theophylline plasma levels should be considered and dosage of
theophylline adjusted as required.
• Quinolones, , have also been shown to interfere with the metabolism of caffeine. This may lead to reduced clearance of caffeine and a prolongation of its plasma half-life.
• Elevated serum levels of cyclosporin have been reported with concomitant
use with floxacines, Cyclosporin serum levels should be monitored and
appropriate cyclosporin dosage adjustments made when these medicines are
used concomitantly.
• Quinolones, may enhance the effects of oral anticoagulants including warfarin or its derivatives, Heparins (Low & High molecular heparins like Fondaparin, Enaxaparin etc) and Nicoumalone (Acitrom) or similar agents commonly used in cardiology and DVT. When these products are administered concomitantly, prothrombin time or other suitable coagulation tests should be closely monitored.
• The concomitant administration of quinolones with Oral Hypoglycemic agents has, on rare occasions, resulted in severe hypoglycemia. Monitoring of blood glucose is recommended when these agents are co-administered.
• Multivitamins, products containing iron or zinc, antacids or sucralfate should not be administered concomitantly with, or within 2 hours of, the administration of floxacines because they may interfere with absorption, resulting in lower serum and urine levels of Floxacines..
• Concomitant administration of a non-steroidal anti-inflammatory drug (NSAID)
with quinolones, may increase the risk of stimulation of central nervous
system and convulsive seizures. Floxacines should be used with caution in
individuals receiving NSAIDs concomitantly. Animal data have shown that
Quinolones in combination with NSAID’s can lead to convulsions.
Concomitant administration of quinolones and NSAID’s should be avoided.
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