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Drug Interactions between gatifloxacin and TheraCys

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

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Interactions between your drugs

Major

BCG gatifloxacin

Applies to: TheraCys (bcg) and gatifloxacin

CONTRAINDICATED: Antituberculosis drugs may interfere with the anti-tumor activity of intravesical BCG, which contains a live, attenuated strain of Mycobacterium bovis. Available data suggest that intravesical BCG may be sensitive to most antibiotics, particularly those that are routinely used in the treatment of tuberculosis such as streptomycin, para-aminosalicylic acid (PAS), isoniazid (INH), rifampin, and ethambutol. It is reportedly not sensitive to pyrazinamide or cycloserine. Regardless of clinical susceptibility data, however, most antibacterials may still interfere with BCG in the bladder due to their high urinary recovery.

MANAGEMENT: Concomitant use of antituberculosis drugs is considered contraindicated during intravesical BCG therapy. Moreover, intravesical BCG should not be used in patients with active tuberculosis. If persistent fever develops or an acute febrile illness consistent with BCG infection occurs during intravesical BCG therapy, the medication should be permanently discontinued and the patient immediately evaluated and treated for BCG infection. An infectious disease consultation should be sought in determining the appropriate treatment. There are no data to suggest that the acute, local urinary tract toxicity common with intravesical administration of BCG is due to mycobacterial infection, thus antituberculosis drugs should not be used to prevent or treat the local, irritative toxicities of intravesical BCG.

References

  1. "Product Information. Tice BCG Live (for intravesical use) (BCG)." Organon
  2. Durek C, Rusch-Gerdes S, Jocham D, Bohle A "Interference of modern antibacterials with bacillus Calmette-Guerin viability." J Urol 162 (1999): 1959-62
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  4. Cerner Multum, Inc. "Australian Product Information." O 0
  5. "Product Information. Tice BCG Live (for intravesical use) (BCG)." Organon Pharmaceuticals PROD
View all 5 references

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Drug and food interactions

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


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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.