Basic Information
ID DDInter326 and DDInter58
Interaction INTERVAL: Coadministration with antacids or agents with acid-neutralizing effects may reduce the oral bioavailability of cefpodoxime proxetil and cefuroxime axetil. The proposed mechanism is a pH-dependent reduction in drug dissolution and absorption.
Management Until further data are available, patients treated with cefpodoxime proxetil or cefuroxime axetil should avoid taking antacids or oral medications that contain antacids (e.g., didanosine buffered tablets or pediatric oral solution) for at least two hours before and after administration of the antibiotic.
References [1] Honig PK, Gillespie BK "Clinical significance of pharmacokinetic drug interactions with over-the-counter (OTC) drugs." Clin Pharmacokinet 35 (1998): 167-71 [2] Saathoff N, Lode H, Neider K, et al "Pharmacokinetics of cefpodoxime and interactions with an antacid and an H2 receptor antagonist." Antimicrob Agents Chemother 36 (1992): 796-800 [3] Hughes GS, Heald DL, Barker KB, et al. "The effects of gastric pH and food on the pharmacokinetics of a new oral cephalosporin, cefpodoxime proxetil." Clin Pharmacol Ther 46 (1989): 674-85 [4] Sommers DK, van Wyk M, Moncrieff J, Schoeman HS "Influence of food and reduced gastric acidity on the bioavailability of bacampicillin and cefuroxime axetil." Br J Clin Pharmacol 18 (1984): 535-9
Alternative for Cefpodoxime J01D
Ertapenem Ceftriaxone Loracarbef Ceftizoxime Cefoxitin Ceftaroline fosamil
Ceftibuten Cephalexin Cefradine Cefamandole Cefmetazole
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Alternative for Aluminum hydroxide -
Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.