Drug Interactions between Biltricide and Flagyl
This report displays the potential drug interactions for the following 2 drugs:
- Biltricide (praziquantel)
- Flagyl (metronidazole)
Interactions between your drugs
No interactions were found between Biltricide and Flagyl. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Biltricide
A total of 102 drugs are known to interact with Biltricide.
- Biltricide is in the drug class anthelmintics.
-
Biltricide is used to treat the following conditions:
- Beef Tapeworm Infection
- Cysticercus cellulosae
- Dog Tapeworm Infection
- Dwarf Tapeworm Infection
- Echinococcus
- Fasciolopsis buski, Intestinal Fluke
- Fish Tapeworm Infection
- Heterophyes heterophyes, Intestinal Fluke
- Liver Fluke
- Metagonimus yokogawai, Intestinal Fluke
- Naophyetus salmincola
- Opisthorchis viverrini, Liver Fluke
- Paragonimus westermani, Lung Fluke
- Pork Tapeworm Infection
- Schistosoma haematobium
- Schistosoma japonicum
- Schistosoma mansoni
- Schistosoma mekongi
Flagyl
A total of 349 drugs are known to interact with Flagyl.
- Flagyl is in the following drug classes: amebicides, miscellaneous antibiotics.
-
Flagyl is used to treat the following conditions:
- Amebiasis
- Aspiration Pneumonia
- Bacteremia
- Bacterial Infection
- Balantidium coli
- Bone infection
- Clostridioides difficile Infection
- Deep Neck Infection
- Dental Abscess
- Dientamoeba fragilis
- Diverticulitis
- Dracunculiasis
- Endocarditis
- Giardiasis
- Helicobacter Pylori Infection
- Intraabdominal Infection
- Joint Infection
- Meningitis
- Nongonococcal Urethritis
- Pelvic Inflammatory Disease
- Peritonitis
- Pneumonia
- Pseudomembranous Colitis
- Skin or Soft Tissue Infection
- STD Prophylaxis
- Surgical Prophylaxis
- Trichomoniasis
Drug and food interactions
metroNIDAZOLE food
Applies to: Flagyl (metronidazole)
CONTRAINDICATED: Use of alcohol or products containing alcohol during nitroimidazole therapy may result in a disulfiram-like reaction in some patients. There have been a few case reports involving metronidazole, although data overall are not convincing. The presumed mechanism is inhibition of aldehyde dehydrogenase (ALDH) by metronidazole in a manner similar to disulfiram. Following ingestion of alcohol, inhibition of ALDH results in increased concentrations of acetaldehyde, the accumulation of which can produce an unpleasant physiologic response referred to as the 'disulfiram reaction'. Symptoms include flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, weakness, vertigo, blurred vision, and confusion. Severe reactions may result in respiratory depression, cardiovascular collapse, arrhythmia, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death. However, some investigators have questioned the disulfiram-like properties of metronidazole. One study found neither elevations in blood acetaldehyde nor objective or subjective signs of a disulfiram-like reaction to ethanol in six subjects treated with metronidazole (200 mg three times a day for 5 days) compared to six subjects who received placebo.
MANAGEMENT: Because clear evidence is lacking concerning the safety of ethanol use during nitroimidazole therapy, patients should be apprised of the potential for interaction. Consumption of alcoholic beverages and products containing propylene glycol is specifically contraindicated during and for at least 3 days after completion of metronidazole and benznidazole therapy according to their product labeling.
References
- Giannini AJ, DeFrance DT (1983) "Metronidazole and alcohol: potential for combinative abuse." J Toxicol Clin Toxicol, 20, p. 509-15
- Alexander I (1985) "Alcohol-antabuse syndrome in patients receiving metronidazole during gynaecological treatment." Br J Clin Pract, 39, p. 292-3
- Harries DP, Teale KF, Sunderland G (1990) "Metronidazole and alcohol: potential problems." Scott Med J, 35, p. 179-80
- (2001) "Product Information. Flagyl (metronidazole)." Searle
- Edwards DL, Fink PC, Van Dyke PO (1986) "Disulfiram-like reaction associated with intravenous trimethoprim-sulfamethoxazole and metronidazole." Clin Pharm, 5, p. 999-1000
- Williams CS, Woodcock KR (2000) "Do ethanol and metronidazole interact to produce a disulfiram-like reaction?." Ann Pharmacother, 34, p. 255-7
- Visapaa JP, Tillonen JS, Kaihovaara PS, Salaspuro MP (2002) "Lack of disulfiram-like reaction with metronidazole and ethanol." Ann Pharmacother, 36, p. 971-4
- Krulewitch CJ (2003) "An unexpected adverse drug effect." J Midwifery Womens Health, 48, p. 67-8
- (2017) "Product Information. Benznidazole (benznidazole)." Everett Laboratories Inc
praziquantel food
Applies to: Biltricide (praziquantel)
ADJUST DOSING INTERVAL: Administration with food increases the oral bioavailability of praziquantel. The mechanism has not been described. In nine healthy volunteers, administration of praziquantel (1800 mg single oral dose) following a high-fat meal increased the mean praziquantel peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 243% and 180%, respectively, compared to administration under fasting conditions. Administration with a high-carbohydrate meal increased these values by 515% and 271%, respectively, compared to fasting. Overall, the relative bioavailability was increased by a factor of 2.72 and 3.98 with the high-fat and high-carbohydrate meals, respectively. The time to reach peak concentration (Tmax) and elimination half-life (T1/2) were not significantly altered.
Coadministration with grapefruit juice may increase the oral bioavailability of praziquantel. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall induced by certain compounds present in grapefruit. In 18 healthy volunteers, administration of praziquantel (1800 mg single oral dose) with 250 mL of commercially squeezed grapefruit juice resulted in increases in the mean praziquantel Cmax and AUC of 63% and 90%, respectively, compared to administration with water. The Tmax and T1/2 were not significantly altered. The pharmacokinetics of praziquantel were subject to a high degree of interpatient variability with and without grapefruit juice.
MANAGEMENT: To ensure maximal oral absorption, praziquantel should be administered with meals. Administration with grapefruit juice may further increase pharmacologic effects of praziquantel, including adverse effects such dizziness, abdominal discomfort, and nausea.
References
- Castro N, Jung H, Medina R, Gonzalez-Esquivel D, Lopez M, Sotelo J (2002) "Interaction between grapefruit juice and praziquantel in humans." Antimicrob Agents Chemother, 46, p. 1614-6
- Castro N, Medina R, Sotelo J, Jung H (2000) "Bioavailability of praziquantel increases with concomitant administration of food." Antimicrob Agents Chemother, 44, p. 2903-4
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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