Ampicillin / probenecid Disease Interactions

There are 10 disease interactions with ampicillin / probenecid:

Beta-Lactams (Parenteral) (Includes Ampicillin/probenecid) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Most beta-lactam antibiotics are eliminated by the kidney as unchanged drug and, in some cases, also as metabolites. The serum concentrations of beta-lactam antibiotics and their metabolites may be increased and the half-lives prolonged in patients with impaired renal function. Neurotoxic reactions, including encephalopathy, asterixis, myoclonus, seizures and coma, have been reported in such patients treated parenterally with these agents. Dosage adjustments may be necessary and modifications should be based on the degree of renal impairment as well as severity of infection in accordance with the individual product package labeling. Renal function tests should be performed periodically during prolonged and/or high-dose therapy, since nephrotoxicity and alterations in renal function have occasionally been associated with the use of these drugs.

References

  1. Jackson EA, McLeod DC "Pharmacokinetics and dosing of antimicrobial agents in renal impairment, part I." Am J Hosp Pharm 31 (1974): 36-52
  2. Aronoff GR, Sloan RS, Stanish RA, Fineberg NS "Mezlocillin dose dependent elimination kinetics in renal impairment." Eur J Clin Pharmacol 21 (1982): 505-9
  3. Kampf D, Schurig R, Korsukewitz I, Bruckner O "Cefoxitin pharmacokinetics: relation to three different renal clearance studies in patients with variuos degrees of renal insufficiency." Antimicrob Agents Chemother 20 (1981): 741-6
View all 153 references

Probenecid (Includes Ampicillin/probenecid) ↔ Blood Dyscrasias

Severe Potential Hazard, Moderate plausibility

Applies to: Anemia, Bone Marrow Depression/Low Blood Counts

The manufacturer does not recommend the use of probenecid in patients with known blood dyscrasias. Aplastic anemia, leukopenia, hemolytic anemia and other anemia have been reported infrequently during administration of probenecid. Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency may increase the risk of probenecid-induced hemolytic anemia.

References

  1. Gutman AB "Uricosuric drugs with special reference to probenecid and sulfinpyrazone." Adv Pharmacol 4 (1966): 91-142
  2. "Product Information. Benemid (probenecid)." Merck & Co, Inc, West Point, PA.
  3. Sosler SD, Behzad O, Garratty G, et al "Immune hemolytic anemia associated with probenecid." Am J Clin Pathol 84 (1985): 391-4
View all 4 references

Probenecid (Includes Ampicillin/probenecid) ↔ Dehydration

Severe Potential Hazard, High plausibility

Applies to: Dehydration, Diarrhea, Vomiting

Probenecid may promote lithiasis by increasing uric acid concentration in the renal tubules. Adequate hydration is necessary during therapy. Patients who are dehydrated (e.g., due to severe diarrhea or vomiting) may be at increased risk for the development of uric acid kidney stones and should be encouraged to consume additional amounts of liquid or given intravenous fluid. In general, fluid intake sufficient to yield a daily urinary output of at least 2 liters is recommended. Maintenance of a slightly alkaline or neutral urine is also desirable.

References

  1. "Product Information. Benemid (probenecid)." Merck & Co, Inc, West Point, PA.
  2. Gutman AB "Uricosuric drugs with special reference to probenecid and sulfinpyrazone." Adv Pharmacol 4 (1966): 91-142

Probenecid (Includes Ampicillin/probenecid) ↔ Uric Acid Nephrolithiasis

Severe Potential Hazard, High plausibility

Applies to: Uric Acid Nephrolithiasis, History - Nephrolithiasis, Gouty Nephropathy

The use of probenecid is not recommended in patients with a history of uric acid nephrolithiasis or a urinary urate excretion greater than 750 mg/24 hr. Probenecid may promote lithiasis by increasing uric acid concentration in the renal tubules. Adequate hydration is necessary during treatment. In general, a fluid intake sufficient to yield a daily urinary output of at least 2 liters is recommended. Maintenance of a slightly alkaline urine is also desirable.

References

  1. "Product Information. Benemid (probenecid)." Merck & Co, Inc, West Point, PA.
  2. Gutman AB "Uricosuric drugs with special reference to probenecid and sulfinpyrazone." Adv Pharmacol 4 (1966): 91-142

Aminopenicillins (Includes Ampicillin/probenecid) ↔ Mononucleosis

Moderate Potential Hazard, High plausibility

Applies to: Mononucleosis

Patients with mononucleosis treated with an aminopenicillin antibiotic, particularly ampicillin, quite frequently develop a pruritic erythematous maculopapular skin rash that generally occurs 5 to 10 days after therapy is initiated. The rash is usually self-limiting and resolves within days of discontinuing the offending agent. An altered drug metabolism or an immune-mediated process unrelated to drug hypersensitivity has been proposed as the underlying mechanism. Clinicians should recognize that a skin eruption under this circumstance does not necessarily indicate a life-long allergy to these agents or other penicillin derivatives. Therapy with aminopenicillin antibiotics may not be appropriate in patients with mononucleosis.

References

  1. "Product Information. Polycillin (ampicillin)." Apothecon Inc, Plainsboro, NJ.
  2. Chan HL "Fixed drug eruption to bacampicillin (ampicillin)." Arch Dermatol 120 (1984): 542
  3. "Product Information. Spectrobid (bacampicillin)." Roerig Division, New York, NY.
View all 7 references

Ampicillin (Includes Ampicillin/probenecid) ↔ Sodium

Moderate Potential Hazard, High plausibility

Applies to: Congestive Heart Failure, Fluid Retention, Hypertension, Hypernatremia

Parenteral ampicillin sodium contains approximately 67 to 71 mg (2.9 to 3.1 mEq) of sodium per each gram of ampicilliin activity. The combination, ampicillin-sulbactam, contains approximately 115 mg (5 mEq) of sodium per 1.5 gram of total drug. The sodium content should be considered when these products are used in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.

References

  1. "Product Information. Unasyn (ampicillin-sulbactam)." Roerig Division, New York, NY.
  2. "Product Information. Omnipen (ampicillin)." Wyeth-Ayerst Laboratories, Philadelphia, PA.

Antibiotics (Includes Ampicillin/probenecid) ↔ Colitis

Moderate Potential Hazard, Moderate plausibility

Applies to: Colitis/Enteritis (Noninfectious)

Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to two months following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic-associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.

References

  1. Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
  2. Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
  3. Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
View all 47 references

Penicillins (Includes Ampicillin/probenecid) ↔ Hemodialysis

Moderate Potential Hazard, High plausibility

Applies to: hemodialysis

Penicillin antibiotics (except for agents in the penicillinase-resistant class) are removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.

References

  1. Francke EL, Appel GB, Neu HC "Kinetics of intravenous amoxicillin in patients on long-term dialysis." Clin Pharmacol Ther 26 (1979): 31-5
  2. Davies BE, Boon R, Horton R, Reubi FC, Descoeudres CE "Pharmacokinetics of amoxycillin and clavulanic acid in haemodialysis patients following intravenous administration of augmentin." Br J Clin Pharmacol 26 (1988): 385-90
  3. Reitberg DP, Marble DA, Schultz RW, Whall TJ, Schentag JJ "Pharmacokinetics of cefoperazone (2.0 g) and sulbactam (1.0 g) coadministered to subjects with normal renal function, patients with decreased renal function, and patients with end-stage renal disease on hemodialysis." Antimicrob Agents Chemother 32 (1988): 503-9
View all 22 references

Probenecid (Includes Ampicillin/probenecid) ↔ Pud

Moderate Potential Hazard, Low plausibility

Applies to: Peptic Ulcer, History - Peptic Ulcer

The manufacturer states that probenecid should be used with caution in patients with a history of peptic ulcer. Uricosuric agents can cause upper gastrointestinal irritation and aggravate or reactivate peptic ulcer. However, these effects have primarily been reported with another uricosuric agent, sulfinpyrazone. GI effects associated with probenecid are usually limited to nausea, vomiting, and anorexia.

References

  1. "Product Information. Benemid (probenecid)." Merck & Co, Inc, West Point, PA.

Probenecid (Includes Ampicillin/probenecid) ↔ Renal Dysfunction

Moderate Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Probenecid may not be effective in patients with chronic renal insufficiency, particularly if creatinine clearance is below 50 mL/min. Probenecid has been used in patients with some renal impairment but dosage requirements may be increased.

References

  1. Scott JT, O'Brien PK "Probenecid, nephrotic syndrome, and renal failure." Ann Rheum Dis 27 (1968): 249-52
  2. "Product Information. Benemid (probenecid)." Merck & Co, Inc, West Point, PA.

You should also know about...

ampicillin / probenecid drug Interactions

There are 374 drug interactions with ampicillin / probenecid

ampicillin / probenecid alcohol/food Interactions

There are 2 alcohol/food interactions with ampicillin / probenecid

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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