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Drug Interactions between fecal microbiota, live and Panixine

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

cephalexin fecal microbiota, live

Applies to: Panixine (cephalexin) and fecal microbiota, live

ADJUST DOSING INTERVAL: Antibiotics may interfere with the therapeutic effects of fecal microbiota, which contains live bacteria. The mechanism may be related to the antibiotic inactivating the bacteria or reducing bacterial replication. In clinical studies an antibiotic washout period between 24 to 72 hours was required prior to the rectal administration of fecal microbiota.

MANAGEMENT: Although data are limited, it may be prudent to have an antibiotic washout period between 24 to 72 hours prior to administration of the rectal formulation of fecal microbiota. In addition, the manufacturer recommends avoiding oral antibiotics for up to 8 weeks after administration of the rectal formulation of fecal microbiota.

References

  1. (2022) "Product Information. Rebyota (fecal microbiota, live)." Ferring Pharmaceuticals Inc
  2. singh p, Alm EJ, Kelley JM, Cheng V, Smith M, Kassam Z, Nee J, Iturrino J, Lembo A (2022) "Effect of antibiotic pretreatment on bacterial engraftment after Fecal Microbiota Transplant (FMT) in IBS-D" National Library of Medicine, 14, p. 1

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Drug and food interactions

Moderate

cephalexin food

Applies to: Panixine (cephalexin)

ADJUST DOSING INTERVAL: Oral products containing zinc such as mineral supplements and multivitamins may interfere with the gastrointestinal absorption of cephalexin, ceftibuten or cephradine. In one pharmacokinetic study (n=12), concurrent administration of zinc sulfate (250 mg, single oral dose) and cephalexin (500 mg, single oral dose) decreased cephalexin maximum concentration (Cmax) and systemic exposure (AUC; 0-inf) by 31.05% and 27.4%, respectively. However, in the same study, when zinc sulfate was administered 3 hours after the cephalexin dose, no significant alteration in cephalexin pharmacokinetics were observed.

MANAGEMENT: Oral medications or mineral supplements that contain zinc are recommended to be administered at least 3 hours after the cephalexin, ceftibuten or cephradine dose.

References

  1. Ding Y, Jia Y, Li F, et al. (2011) "The Effect of Staggered Administration of Zinc Sulfate on the Pharmacokinetics of Oral Cephalexin*" Br J Clin Pharmacol, 73, p. 422-7
  2. World Health Organization (2020) WHO Public Assessment Reports (WHOPARs) https://extranet.who.int/pqweb/medicines/prequalification-reports/whopars
  3. Okamura M, Terada t, KatsuraT, Saito H, Inui K (2003) "Inhibitory effect of zinc on PEPT1-mediated transport of glycylsarcosine and beta-lactam antibiotics in human intestinal cell line Caco-2" Pharm Res, 20, p. 1389-93

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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

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown 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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