Oxytetracycline / phenazopyridine / sulfamethizole Disease Interactions
There are 8 disease interactions with oxytetracycline / phenazopyridine / sulfamethizole:
- G-6-Pd Deficiency
- Renal Dysfunction
- Renal Dysfunction
- Esophageal Irritation
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 several weeks 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.
Patients with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency may be at increased risk for phenazopyridine-induced methemoglobinemia and hemolytic anemia. These conditions have occurred rarely in other patients, except due to acute phenazopyridine overdose or impaired renal function. Therapy with phenazopyridine should be administered cautiously in patients with G-6-PD deficiency.
The use of phenazopyridine is contraindicated in patients with severe hepatitis. Rare cases of hepatotoxicity have been associated with phenazopyridine, usually at overdose levels. Hypersensitivity hepatitis has also been reported. Therapy with phenazopyridine should be administered cautiously in patients with impaired hepatic function.
The use of phenazopyridine is contraindicated in patients with impaired renal function. Phenazopyridine is primarily eliminated unchanged by the kidney and may accumulate to toxic levels during prolonged administration in such patients. Reported cases of toxicity due to overdosage have resulted in acute renal failure and methemoglobinemia. Likewise, administration of phenazopyridine to patients with preexisting renal failure has led to methemoglobinemia and hemolytic anemia. Phenazopyridine toxicity may be associated with a yellowish tinge of the skin or sclera.
Oxytetracycline is partially removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.
The use of tetracyclines has rarely been associated with hepatotoxicity. Histologic fatty changes of the liver, elevated liver enzymes, and jaundice have been reported, primarily in patients treated with large doses of intravenous tetracycline hydrochloride (no longer available in the U.S.) but also in patients receiving high oral doses of these drugs. Therapy with tetracyclines should be administered cautiously in patients with preexisting liver disease or biliary obstruction. Reduced dosages may be appropriate, particularly with minocycline and doxycycline, since the former is metabolized by the liver and the latter undergoes enterohepatic recycling. Liver function tests are recommended prior to and during therapy, and the concomitant use of other potentially hepatotoxic drugs should be avoided.
Tetracyclines (except doxycycline) are eliminated by the kidney to various extent. Patients with renal impairment may be at greater risk for tetracycline-associated hepatic and/or renal toxicity (increased BUN with consequent azotemia, hyperphosphatemia, and acidosis) due to decreased drug clearance. Therapy with tetracyclines should be administered cautiously at reduced dosages in patients with renal impairment. Clinical monitoring of renal and liver function is recommended, and serum tetracycline levels may be necessary during prolonged therapy.
The use of oral tetracycline capsules and tablets has been associated with esophageal irritation and ulceration in patients who ingested the drug without sufficient fluid shortly before bedtime. Therapy with solid formulations of tetracyclines should preferably be avoided in patients with esophageal obstruction, compression or dyskinesia. If the drugs are used, patients should be advised not to take the medication just before retiring and to drink fluids liberally.
You should also know about...
oxytetracycline / phenazopyridine / sulfamethizole drug Interactions
There are 355 drug interactions with oxytetracycline / phenazopyridine / sulfamethizole
oxytetracycline / phenazopyridine / sulfamethizole alcohol/food Interactions
There are 2 alcohol/food interactions with oxytetracycline / phenazopyridine / sulfamethizole
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.
Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date, and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. Multum's drug information does not endorse drugs, diagnose patients, or recommend therapy. Multum's drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug of drug combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2013 Multum Information Services, Inc. The information in contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.