Drug Interactions between metronidazole and Xanax
This report displays the potential drug interactions for the following 2 drugs:
- metronidazole
- Xanax (alprazolam)
Interactions between your drugs
No interactions were found between metronidazole and Xanax. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
metronidazole
A total of 349 drugs are known to interact with metronidazole.
- Metronidazole is in the following drug classes: amebicides, miscellaneous antibiotics.
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Metronidazole is used to treat the following conditions:
- Amebiasis
- Aspiration Pneumonia
- Bacteremia
- Bacterial Infection
- Bacterial Vaginosis
- Balantidium coli
- Bone infection
- Clostridioides difficile Infection
- Crohn's Disease, Active (off-label)
- Crohn's Disease, Maintenance (off-label)
- Deep Neck Infection
- Dental Abscess
- Dientamoeba fragilis
- Diverticulitis
- Dracunculiasis
- Endocarditis
- Gastrointestinal Perforation (off-label)
- Giardiasis
- Helicobacter Pylori Infection
- Intraabdominal Infection
- Joint Infection
- Lemierre's Syndrome
- Meningitis
- Nongonococcal Urethritis
- Pelvic Inflammatory Disease
- Peritonitis
- Pneumonia
- Pouchitis
- Pseudomembranous Colitis
- Skin and Structure Infection
- Skin or Soft Tissue Infection
- STD Prophylaxis
- Surgical Prophylaxis
- Trichomoniasis
Xanax
A total of 549 drugs are known to interact with Xanax.
- Xanax is in the drug class benzodiazepines.
- Xanax is used to treat the following conditions:
Drug and food interactions
metroNIDAZOLE food
Applies to: 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 "Metronidazole and alcohol: potential for combinative abuse." J Toxicol Clin Toxicol 20 (1983): 509-15
- Alexander I "Alcohol-antabuse syndrome in patients receiving metronidazole during gynaecological treatment." Br J Clin Pract 39 (1985): 292-3
- Harries DP, Teale KF, Sunderland G "Metronidazole and alcohol: potential problems." Scott Med J 35 (1990): 179-80
- "Product Information. Flagyl (metronidazole)." Searle PROD (2001):
- Edwards DL, Fink PC, Van Dyke PO "Disulfiram-like reaction associated with intravenous trimethoprim-sulfamethoxazole and metronidazole." Clin Pharm 5 (1986): 999-1000
- Williams CS, Woodcock KR "Do ethanol and metronidazole interact to produce a disulfiram-like reaction?." Ann Pharmacother 34 (2000): 255-7
- Visapaa JP, Tillonen JS, Kaihovaara PS, Salaspuro MP "Lack of disulfiram-like reaction with metronidazole and ethanol." Ann Pharmacother 36 (2002): 971-4
- Krulewitch CJ "An unexpected adverse drug effect." J Midwifery Womens Health 48 (2003): 67-8
- "Product Information. Benznidazole (benznidazole)." Everett Laboratories Inc (2017):
ALPRAZolam food
Applies to: Xanax (alprazolam)
GENERALLY AVOID: The pharmacologic activity of oral midazolam, triazolam, and alprazolam may be increased if taken after drinking grapefruit juice. The proposed mechanism is CYP450 3A4 enzyme inhibition. In addition, acute alcohol ingestion may potentiate CNS depression and other CNS effects of many benzodiazepines. Tolerance may develop with chronic ethanol use. The mechanism may be decreased clearance of the benzodiazepines because of CYP450 hepatic enzyme inhibition. Also, it has been suggested that the cognitive deficits induced by benzodiazepines may be increased in patients who chronically consume large amounts of alcohol.
MANAGEMENT: The manufacturer recommends that grapefruit juice should not be taken with oral midazolam. Patients taking triazolam or alprazolam should be monitored for excessive sedation. Alternatively, the patient could consume orange juice which does not interact with these drugs. Patients should be advised to avoid alcohol during benzodiazepine therapy.
References
- "Product Information. Xanax (alprazolam)." Pharmacia and Upjohn PROD (2002):
- "Product Information. Valium (diazepam)." Roche Laboratories PROD (2002):
- "Product Information. Halcion (triazolam)." Pharmacia and Upjohn PROD (2001):
- "Grapefruit juice interactions with drugs." Med Lett Drugs Ther 37 (1995): 73-4
- Kupferschmidt HHT, Ha HR, Ziegler WH, Meier PJ, Krahenbuhl S "Interaction between grapefruit juice and midazolam in humans." Clin Pharmacol Ther 58 (1995): 20-8
- Hukkinen SK, Varhe A, Olkkola KT, Neuvonen PJ "Plasma concentrations of triazolam are increased by concomitant ingestion of grapefruit juice." Clin Pharmacol Ther 58 (1995): 127-31
- Bailey DG, Dresser GR, Kreeft JH, Munoz C, Freeman DJ, Bend JR "Grapefruit-felodipine interaction: Effect of unprocessed fruit and probable active ingredients." Clin Pharmacol Ther 68 (2000): 468-77
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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