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Drug Interactions between gatifloxacin and lanthanum carbonate

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

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Interactions between your drugs

Moderate

gatifloxacin lanthanum carbonate

Applies to: gatifloxacin and lanthanum carbonate

ADJUST DOSING INTERVAL: Theoretically, lanthanum carbonate may chelate with certain drugs in the gastrointestinal tract, resulting in reduced oral bioavailability of those drugs during coadministration. However, an in vitro study involving digoxin, enalapril, furosemide, metoprolol, phenytoin, and warfarin found no evidence that lanthanum carbonate forms insoluble complexes with these drugs in simulated gastric fluid. Studies in healthy subjects have also found no effect of lanthanum carbonate (1000 mg for 4 doses) on the absorption of a single dose of digoxin (0.5 mg), metoprolol (100 mg), or warfarin (10 mg).

MANAGEMENT: To minimize the potential for interaction, drugs that are known to interact with antacids (e.g., ACE inhibitors, beta blockers, bisphosphonates, coumarin derivatives, digitalis glycosides, fluoroquinolones, iron, phenytoin, rifampin, tetracyclines, thyroid preparations) should not be taken within 2 hours of administration of lanthanum carbonate according to the product labeling.

References

  1. (2004) "Product Information. Fosrenol (lanthanum carbonate)." Shire US Inc
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
  4. Cerner Multum, Inc. "Australian Product Information."
  5. (2018) "Product Information. Seysara (sarecycline)." Allergan Inc
  6. (2018) "Product Information. Nuzyra (omadacycline)." Paratek Pharmaceuticals, Inc.
View all 6 references

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Drug and food interactions

Moderate

lanthanum carbonate food

Applies to: lanthanum carbonate

GENERALLY AVOID: Lanthanum carbonate should be administered with food for therapeutic efficacy. However, it is insoluble in water (<0.01 mg/mL at pH 7.5) and therefore cannot be dissolved in liquid for administration through an enteral feeding tube, because it may result in blockage of the tube.

MANAGEMENT: Administration of lanthanum carbonate with enteral feedings is not recommended. Alternative medications such as calcium carbonate suspension should be considered.

References

  1. Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT (2009) "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm, 66, p. 1438-67

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Minor

gatifloxacin food

Applies to: gatifloxacin

Concurrent ingestion of calcium-fortified foods (i.e., cereal, orange juice) may alter the bioavailability of gatifloxacin. The mechanism is chelation of calcium and the quinolone, resulting in decreased bioavailability. In the case of orange juice, inhibition of intestinal transport mechanisms (P-glycoprotein or organic anion-transporting polypeptides) by flavones may also be involved. Data have been conflicting: One study has reported no effect with milk coadministration. Another study reported a modest decrease in gatifloxacin bioavailability (13.5% decrease in Cmax,12% decrease in AUC, 15% increase in total clearance) when taken with 12 ounces of calcium-fortified orange juice instead of water, which could be clinically significant if the infecting organisms have borderline susceptibilities. The manufacturer states that gatifloxacin may be taken without regard to food, milk, or calcium. Clinicians should be aware of the possibility of an interaction if subtherapeutic effects are observed.

References

  1. (2001) "Product Information. Tequin (gatifloxacin)." Bristol-Myers Squibb
  2. Wallace AW, Victory JM, Amsden GW (2003) "Lack of bioequivalence of gatifloxacin when coadministered with calcium-fortified orange juice in healthy volunteers." J Clin Pharmacol, 43, p. 92-6

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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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