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Azithromycin / trovafloxacin Disease Interactions

There are 9 disease interactions with azithromycin / trovafloxacin:

Major

Antibiotics (applies to azithromycin/trovafloxacin) colitis

Major Potential Hazard, Moderate plausibility. Applicable conditions: Colitis/Enteritis (Noninfectious)

Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.

References

  1. Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
  2. Saadah HA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 93 (1980): 645
  3. Daly JJ, Chowdary KV "Pseudomembranous colitis secondary to metronidazole." Dig Dis Sci 28 (1983): 573-4
  4. Trexler MF, Fraser TG, Jones MP "Fulminant pseudomembranous colitis caused by clindamycin phosphate vaginal cream." Am J Gastroenterol 92 (1997): 2112-3
  5. Lyon JA "Imipenem/cilastatin: the first carbapenem antibiotic." Drug Intell Clin Pharm 19 (1985): 894-8
  6. O'Meara TF, Simmons RA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 92 (1980): 440-1
  7. Bauwens JE, McFarland LV, Melcher SA "Recurrent clostridium difficile disease following ciprofloxacin use." Ann Pharmacother 31 (1997): 1090
  8. Meadowcroft AM, Diaz PR, Latham GS "Clostridium difficile toxin-induced colitis after use of clindmycin phosphate vaginal cream." Ann Pharmacother 32 (1998): 309-11
  9. Dan M, Samra Z "Clostridium difficile colitis associated with ofloxacin therapy." Am J Med 87 (1989): 479
  10. Ehrenpreis ED, Lievens MW, Craig RM "Clostridium difficile-associated diarrhea after norfloxacin." J Clin Gastroenterol 12 (1990): 188-9
  11. Bernstein L "Adverse reaction to trimethoprim-sulfamethoxazole, with particular reference to long-term therapy." Can Med Assoc J 112 (1975): s96-8
  12. Cone JB, Wetzel W "Toxic megacolon secondary to pseudomembranous colitis." Dis Colon Rectum 25 (1982): 478-82
  13. Osler T, Lott D, Bordley J, et al "Cefazolin-induced pseudomembranous colitis resulting in perforation of the sigmoid colon." Dis Colon Rectum 29 (1986): 140-3
  14. Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
  15. Parry MF, Rha CK "Pseudomembranous colitis caused by topical clindamycin phosphate." Arch Dermatol 122 (1986): 583-4
  16. Clissold SP, Todd PA, Campoli-Richards DM "Imipenem/cilastatin: a review of its antibacterial activity, pharmacokinetic properties and therapeutic efficacy." Drugs 33 (1987): 185-241
  17. Van Ness MM, Cattau EL Jr "Fulminant colitis complicating antibiotic-associated pseudomembranous colitis: case report and review of the clinical manifestations and treatment." Am J Gastroenterol 82 (1987): 374-7
  18. Cannon SR, Dyson PH, Sanderson PJ "Pseudomembranous colitis associated with antibiotic prophylaxis in orthopaedic surgery." J Bone Joint Surg Br 70-B (1988): 600-2
  19. Miller DL, Sedlack JD, Holt RW "Perforation complicating rifampin-associated pseudomembranous enteritis." Arch Surg 124 (1989): 1082
  20. Miller SN, Ringler RP "Vancomycin-induced pseudomembranous colitis." J Clin Gastroenterol 9 (1987): 114-5
  21. Wang C, Calandra GB, Aziz MA, Brown KR "Efficacy and safety of imipenem/cilastatin: a review of worldwide clinical experience." Rev Infect Dis 7 (1985): s528-36
  22. Hinton NA "The effect of oral tetracycline HCl and doxycycline on the intestinal flora." Curr Ther Res Clin Exp 12 (1970): 341-52
  23. Pokorney BH, Nichols TW, Jr "Pseudomembranous colitis. A complication of sulfasalazine therapy in a patient with Crohn's colitis." Am J Gastroenterol 76 (1981): 374-6
  24. Sankarankutty M, McGeorge D, Galasko CS "Pseudomembranous colitis following cephradine prophylaxis." Postgrad Med J 58 (1982): 726-8
  25. Sugarman B "Trimethoprim-sulfamethoxazole, pseudomembranous colitis, and spinal cord injury." South Med J 78 (1985): 711-3
  26. Gordin F, Gibert C, Schmidt ME "Clostridium difficile colitis associated with trimethoprim-sulfamethoxazole given as prophylaxis for pneumocystis carinii pneumonia." Am J Med 96 (1994): 94-5
  27. Saginur R, Hawley CR, Bartlett JG "Colitis associated with metronidazole therapy." J Infect Dis 141 (1980): 772-4
  28. Golledge CL, Riley TV "Clostridium difficile-associated diarrhoea after doxycycline malaria prophylaxis." Lancet 345 (1995): 1377-8
  29. Edlund C, Lidbeck A, Kager L, Nord CE "Effect of enoxacin on colonic microflora of healthy volunteers." Eur J Clin Microbiol 6 (1987): 298-300
  30. Ring FA, Hershfield NB, Machin GA, Scott RB "Sulfasalazine-induced colitis complicating idiopathic ulcerative colitis." Can Med Assoc J 131 (1984): 43-5
  31. Friedman RJ, Mayer IE, Galambos JT, Hersh T "Oxacillin-induced pseudomembranous colitis." Am J Gastroenterol 73 (1980): 445-7
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  33. Leigh DA, Simmons K, Williams S "Gastrointestinal side effects following clindamycin and lincomycin treatment: a follow up study." J Antimicrob Chemother 6 (1980): 639-45
  34. Davies J, Beck E "Recurrent colitis following antibiotic-associated pseudomembranous colitis." Postgrad Med J 57 (1981): 599-601
  35. Hecht JR, Olinger EJ "Clostridium difficile colitis secondary to intravenous vancomycin." Dig Dis Sci 34 (1989): 148-9
  36. Brause BD, Romankiewicz JA, Gotz V, Franklin JE Jr, Roberts RB "Comparative study of diarrhea associated with clindamycin and ampicillin therapy." Am J Gastroenterol 73 (1980): 244-8
  37. Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
  38. Milstone EB, McDonald AJ, Scholhamer CF Jr "Pseudomembranous colitis after topical application of clindamycin." Arch Dermatol 117 (1981): 154-5
  39. Burt RA "A review of the drug events reported by 12,917 patients treated with cephalexin." Postgrad Med J 59 (1983): 47-50,51-3
  40. Calandra GB, Brown KR, Grad LC, et al "Review of adverse experiences and tolerability in the first 2,516 patients treated with imipenem/cilastatin." Am J Med 78 (1985): 73-8
  41. Bingley PJ, Harding GM "Clostridium difficile colitis following treatment with metronidazole and vancomycin." Postgrad Med J 63 (1987): 993-4
  42. Hutcheon DF, Milligan FD, Yardley JH, Hendrix TR "Cephalosporin-associated pseudomembranous colitis." Am J Dig Dis 23 (1978): 321-6
  43. Midtvedt T, Carlstedt-Duke B, Hoverstad T, et al "Influence of peroral antibiotics upon the biotransformatory activity of the intestinal microflora in healthy subjects." Eur J Clin Invest 16 (1986): 11-7
  44. Altamirano A, Bondani A "Adverse reactions to furazolidone and other drugs. A comparative review." Scand J Gastroenterol Suppl 169 (1989): 70-80
  45. Boriello SP, Jones RH, Phillips I "Rifampicin-associated pseudomembranous colitis." Br Med J 281 (1980): 1180-1
  46. Klinger D, Radford P, Collin J "Pneumoperitoneum without faecal peritonitis in a patient with pseudomembranous colitis." Br Med J 288 (1984): 1271-2
  47. Edlund C, Brismar B, Nord CE "Effect of lomefloxacin on the normal oral and intestinal microflora." Eur J Clin Microbiol Infect Dis 1 (1990): 35-9
View all 47 references
Major

Macrolide antibiotics (applies to azithromycin/trovafloxacin) QT prolongation

Major Potential Hazard, High plausibility. Applicable conditions: Hypokalemia, Magnesium Imbalance, Arrhythmias

Prolonged cardiac repolarization and QT interval have been reported in patients receiving treatment with macrolides. Providers should weight risks and benefits of using these drugs in patients with known prolongation of the QT interval, history of torsades de pointes, congenital long QT syndrome, bradyarrhythmias, proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia, or patients receiving other drugs that prolong the QT interval.

Major

Quinolones (applies to azithromycin/trovafloxacin) CNS disorders

Major Potential Hazard, Moderate plausibility.

Quinolones may cause CNS stimulation manifested as tremors, agitation, restlessness, anxiety, confusion, hallucinations, paranoia, insomnia, toxic psychosis, and/or seizures. Benign intracranial hypertension has also been reported. Therapy with quinolones should be administered cautiously in patients with or predisposed to seizures or other CNS abnormalities. In addition, these patients should be advised to avoid the consumption of caffeine-containing products during therapy with some quinolones, most notably ciprofloxacin, enoxacin, and cinoxacin, since these agents can substantially reduce the clearance of caffeine and other methylxanthines, potentially resulting in severe CNS reactions.

References

  1. Wadworth AN, Goa KL "Lomefloxacin: a review of its antibacterial activity, pharmacokinetic properties and therapeutic use." Drugs 42 (1991): 1018-60
  2. Schwartz MT, Calvert JF "Potential neurologic toxicity related to ciprofloxacin." Ann Pharmacother 24 (1990): 138-40
  3. Jaber LA, Bailey EM, Rybak MJ "Enoxacin: a new fluoroquinolone." Clin Pharm 8 (1989): 97-107
  4. Arcieri G, Griffith E, Gruenwaldt G, et al "A survey of clinical experience with ciprofloxacin, a new quinolone antimicrobial." J Clin Pharmacol 28 (1988): 179-89
  5. Cox CE, Simmons JR "Cinoxacin therapy for urinary tract infections: therapeutic safety and efficacy." South Med J 75 (1982): 549-50
  6. "Product Information. Levaquin (levofloxacin)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  7. Karki SD, Bentley DW, Raghavan M "Seizure with ciprofloxacin and theophylline combined therapy." DICP 24 (1990): 595-6
  8. Todd PA, Faulds D "Ofloxacin: a reappraisal of its antimicrobial activity, pharmacology, and therapeutic use." Drugs 42 (1991): 825-76
  9. Ernst ME, Ernst EJ, Klepser ME "Levofloxacin and trovafloxacin: the next generation of fluoroquinolones?" Am J Health Syst Pharm 54 (1997): 2569-84
  10. Darwish T "Ciprofloxacin-induced seizures in a healthy patient." N Z Med J 121 (2008): 104-5
  11. "Product Information. Cipro (ciprofloxacin)." Bayer, West Haven, CT.
  12. Fennig S, Mauas L "Ofloxacin-induced delirium." J Clin Psychiatry 53 (1992): 137-8
  13. "Product Information. Floxin (ofloxacin)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  14. Isaacson SH, Carr J, Rowan AJ "Ciprofloxacin-induced complex partial status epilepticus manifesting as an acute confusional state." Neurology 43 (1993): 1619-21
  15. Sisca TS, Heel RC, Romankiewicz JA "Cinoxacin. A review of its pharmacological properties and therapeutic efficacy in the treatment of urinary tract infections." Drugs 25 (1983): 544-69
  16. Arcieri G, August R, Becker N, et al "Clinical experience with ciprofloxacin in the USA." Eur J Clin Microbiol 5 (1986): 220-5
  17. "Product Information. Cinobac (cinoxacin)." Oclassen Pharmaceuticals Inc, San Rafael, CA.
  18. Burt RA "Review of adverse reactions associated with cinoxacin and other drugs used to treat urinary tract infections." Urology 23 (1984): 101-7
  19. Haria M, Lamb HM "Trovafloxacin." Drugs 54 (1997): 435-45;disc. 446
  20. Kremer L, Walton M, Wardle EN "Nalidixic acid and intracranial hypertension." Br Med J 4 (1967): 488
  21. Bednarczyk EM, Green JA, Nelson D, et al "Comparative assessment of the effect of lomefloxacin, ciprofloxacin, and placebo on cerebral blood flow, and glucose and oxygen metabolism in healthy subjects by position emission tomography." Pharmacotherapy 12 (1992): 369-75
  22. Stamey TA "Cinoxacin: an overview." Urology 17 (1981): 492-5
  23. Thomas RJ, Regan DR "Association of a tourette-like syndrome with ofloxacin." Ann Pharmacother 30 (1996): 138-41
  24. Just PM "Overview of the fluoroquinolone antibiotics." Pharmacotherapy 13 (1993): s4-17
  25. Getenet JC, Croisile B, Vighetto A, et al. "Idiopathic intracranial hypertension after ofloxacin treatment." Acta Neurol Scand 87 (1993): 503-4
  26. Poc TE, Marion GS, Jackson DS "Seizures due to nalidixic acid therapy." South Med J 77 (1984): 539-40
  27. "Product Information. Penetrex (enoxacin)." Rhone-Poulenc Rorer, Collegeville, PA.
  28. Rosolen A, Drigo P, Zanesco L "Acute hemiparesis associated with ciprofloxacin." BMJ 309 (1994): 1411
  29. "Product Information. Trovan (trovafloxacin)." Pfizer US Pharmaceuticals, New York, NY.
  30. "Product Information. Zagam (sparfloxacin)." Rhone-Poulenc Rorer, Collegeville, PA.
  31. Akhtar S, Ahmad H "Ciprofloxacin-induced catatonia." J Clin Psychiatry 54 (1993): 115-6
  32. Slavich IL, Gleffe Rf, Haas EJ "Grand mal epileptic seizures during ciprofloxacin therapy." JAMA 261 (1989): 558-9
  33. Traeger SM, Bonfiglio MF, Wilson JA, Martin BR, Nackes NA "Seizures associated with ofloxacin therapy." Clin Infect Dis 21 (1995): 1504-6
  34. "Product Information. Maxaquin (lomefloxacin)." Searle, Skokie, IL.
  35. Moore B, Safani M, Keesey J "Possible exacerbation of myasthenia gravis by ciprofloxacin." Lancet Jan (1988): 882
  36. De Sarro A, De Sarro G "Adverse reactions to fluoroquinolones. An overview on mechanistic aspects." Curr Med Chem 8 (2001): 371-84
  37. Semel JD, Allen N "Seizures in patients simultaneously receiving theophylline and imipenem or ciprofloxacin or metronidazole." South Med J 84 (1991): 465-8
  38. McCue JD, Zandt JR "Acute psychoses associated with the use of ciprofloxacin and trimethoprim-sulfamethoxazole." Am J Med 90 (1991): 528-9
  39. Unseld E, Ziegler G, Gemeinhardt A, Janssen U, Klotz U "Possible interaction of fluoroquinolones with benzodiazepine-GABA-receptorn complex." Br J Clin Pharmacol 30 (1990): 63-70
  40. Altes J, Gasco J, De Antonio J, Villalonga C "Ciprofloxacin and delirium." Ann Intern Med 110 (1989): 170-1
  41. Schacht P, Arcieri G, Hullmann R "Safety of oral ciprofloxacin. An update based on clinical trial results." Am J Med 87 (1989): s98-102
  42. Anastasio GD, Menscer D, Little JM "Norfloxacin and seizures." Ann Intern Med 109 (1988): 169-70
  43. McDermott JL, Gideonse N, Campbell JW "Acute delirium associated with ciprofloxacin administration in a hospitalized elderly patient." J Am Geriatr Soc 39 (1991): 909-10
  44. Fanhavard P, Sanchorawala V, Oh J, Moser EM, Smith SP "Concurrent use of foscarnet and ciprofloxacin may increase the propensity for seizures." Ann Pharmacother 28 (1994): 869-72
  45. "Product Information. Tequin (gatifloxacin)" Bristol-Myers Squibb, Princeton, NJ.
  46. Ball P "Ciprofloxacin: an overview of adverse experiences." J Antimicrob Chemother 18 (1986): 187-93
  47. Tack KJ, Smith JA "The safety profile of ofloxacin." Am J Med 87 (1989): s78-81
  48. "Product Information. NegGram (nalidixic acid)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  49. "Product Information. Avelox (moxifloxacin)" Bayer, West Haven, CT.
  50. Melvani S, Speed BR "Alatrofloxacin-induced seizures during slow intravenous infusion." Ann Pharmacother 34 (2000): 1017-9
  51. Winrow AP, Supramaniam G "Benign intracranial hypertension after ciprofloxacin administration." Arch Dis Child 65 (1990): 1165-6
  52. Leslie PJ, Cregeen RJ, Proudfoot AT "Lactic acidosis, hyperglycaemia and convulsions following nalidixic acid overdosage." Hum Toxicol 3 (1984): 239-43
  53. Norrby SR "Side-effects of quinolones: comparisons between quinolones and other antibiotics." Eur J Clin Microbiol Infect Dis 10 (1991): 378-83
  54. "Product Information. Noroxin (norfloxacin)." Merck & Co, Inc, West Point, PA.
  55. Fraser AG, Harrower AD "Convulsions and hyperglycaemia asociated with nalidixic acid." Br Med J 2 (1977): 1518
  56. Walton GD, Hon JK, Mulpur TG "Ofloxacin-induced seizure." Ann Pharmacother 31 (1997): 1475-7
  57. "Product Information. Factive (gemifloxacin)." GeneSoft Inc, San Francisco, CA.
View all 57 references
Major

Quinolones (applies to azithromycin/trovafloxacin) myasthenia gravis

Major Potential Hazard, Moderate plausibility.

Fluoroquinolones have neuromuscular blocking activity and may exacerbate muscle weakness in persons with myasthenia gravis. Postmarketing serious adverse events, including deaths and requirement for ventilatory support, have been associated with fluoroquinolones use in persons with myasthenia gravis. Fluoroquinolones should be avoided in patients with history of myasthenia gravis.

Major

Quinolones (applies to azithromycin/trovafloxacin) peripheral neuropathy

Major Potential Hazard, Moderate plausibility.

The use of quinolones has been associated with an increased risk of peripheral neuropathy. Monitor closely and discontinue their use in patients experiencing symptoms of peripheral neuropathy. It is recommended to avoid these agents in patients who have previously experienced peripheral neuropathy.

Major

Quinolones (applies to azithromycin/trovafloxacin) tendonitis

Major Potential Hazard, Moderate plausibility. Applicable conditions: Rheumatoid Arthritis, Renal Dysfunction, Organ Transplant

Tendonitis and ruptures of the shoulder, hand, and Achilles tendons have been reported in patients receiving quinolones, both during and after treatment. Avoid the use of these agents in patients who have a history of tendon disorders or have experienced tendinitis or tendon rupture. Therapy with quinolones should be administered cautiously in patients with patients with kidney, heart, and lung transplant, since it may delay the recognition or confound the diagnosis of a quinolone-induced musculoskeletal effect. Factors that may independently increase the risk of tendon rupture include strenuous physical activity, renal failure, and previous tendon disorders such as rheumatoid arthritis. It is recommended to discontinue these agents if, at any time during therapy, pain, inflammation or rupture of a tendon develops and institute appropriate treatment.

References

  1. "Product Information. Penetrex (enoxacin)." Rhone-Poulenc Rorer, Collegeville, PA.
  2. "Product Information. Trovan (trovafloxacin)." Pfizer US Pharmaceuticals, New York, NY.
  3. "Product Information. Factive (gemifloxacin)." GeneSoft Inc, San Francisco, CA.
  4. Casparian JM, Luchi M, Moffat RE, Hinthorn D "Quinolones and tendon ruptures." South Med J 93 (2000): 392-6
  5. "Product Information. Noroxin (norfloxacin)." Merck & Co, Inc, West Point, PA.
  6. Donck JB, Segaert MF, Vanrenterghem YF "Fluoroquinolones and achilles tendinopathy in renal transplant recipients." Transplantation 58 (1994): 736-7
  7. "Product Information. Tequin (gatifloxacin)" Bristol-Myers Squibb, Princeton, NJ.
  8. Carrasco JM, Garcia B, Andujar C, Garrote F, de Juana P, Bermejo T "Tendinitis associated with ciprofloxacin." Ann Pharmacother 31 (1997): 120
  9. "Product Information. Maxaquin (lomefloxacin)." Searle, Skokie, IL.
  10. "Product Information. Levaquin (levofloxacin)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  11. "Product Information. Avelox (moxifloxacin)" Bayer, West Haven, CT.
  12. "Product Information. Floxin (ofloxacin)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  13. "Product Information. NegGram (nalidixic acid)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  14. "Product Information. Cipro (ciprofloxacin)." Bayer, West Haven, CT.
  15. "Product Information. Cinobac (cinoxacin)." Oclassen Pharmaceuticals Inc, San Rafael, CA.
  16. "Product Information. Zagam (sparfloxacin)." Rhone-Poulenc Rorer, Collegeville, PA.
  17. Schacht P, Arcieri G, Hullmann R "Safety of oral ciprofloxacin. An update based on clinical trial results." Am J Med 87 (1989): s98-102
  18. Zabraniecki L, Negrier I, Vergne P, Arnaud M, Bonnet C, Bertin P, Treves R "Fluoroquinolone induced tendinopathy: report of 6 cases." J Rheumatol 23 (1996): 516-20
View all 18 references
Major

Trovafloxacin (applies to azithromycin/trovafloxacin) liver disease

Major Potential Hazard, High plausibility. Applicable conditions: Biliary Obstruction

Trovafloxacin undergoes metabolism by the liver as well as excretion by the hepatobiliary system. Patients with hepatic impairment or biliary obstruction may be at greater risk for adverse effects from trovafloxacin due to decreased drug clearance. Therapy with trovafloxacin should be administered cautiously in these patients. The manufacturer recommends a dosage reduction in mild to moderate cirrhosis. Periodic assessment of hepatic function is advised, especially during prolonged therapy (>= 21 days), since trovafloxacin can also cause elevations of liver enzymes.

References

  1. Teng R, Harris SC, Nix DE, Schentag JJ, Foulds G, Liston TE "Pharmacokinetics and safety of trovafloxacin (CP-99,219), a new quinolone antibiotic, following administration of single oral dose to healthy male volunteers." J Antimicrob Chemother 36 (1995): 385-94
  2. Vincent J, Venitz J, Teng R, Baris BA, Willavize SA, Polzer RJ, Friedman HL "Pharmacokinetics and safety of trovafloxacin in healthy male volunteers following administration of single intravenous doses o the prodrug, alatrofloxacin." J Antimicrob Chemother 39 Suppl B (1997): 75-80
  3. Haria M, Lamb HM "Trovafloxacin." Drugs 54 (1997): 435-45;disc. 446
  4. Teng R, Liston TE, Harris SC "Multiple-dose pharmacokinetics and safety of trovafloxacin in healthy volunteers." J Antimicrob Chemother 37 (1996): 955-63
  5. Dalvie DK, Khosla N, Vincent J "Excretion and metabolism of trovafloxacin in humans." Drug Metab Dispos 25 (1997): 423-7
  6. "Product Information. Trovan (trovafloxacin)." Pfizer US Pharmaceuticals, New York, NY.
View all 6 references
Moderate

Azithromycin (applies to azithromycin/trovafloxacin) liver disease

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Biliary Obstruction

Azithromycin is primarily excreted by the hepatobiliary system. Although the drug is generally well-tolerated and associated with few adverse effects, therapy with azithromycin should be administered cautiously in patients with liver and/or biliary disease. Hepatotoxicity (abnormal liver function, hepatitis, cholestatic jaundice, necrosis and hepatic failure) has been reported. Treatment should be discontinued immediately if signs and symptoms of hepatitis occur. Azithromycin is contraindicated in patients with a history of cholestatic jaundice or hepatic dysfunction associated with the prior use of azithromycin.

References

  1. "Product Information. Azithromycin Product Information (azithromycin)." Pfizer US Pharmaceuticals, New York, NY.
  2. Zuckerman JM, Kaye KM "The newer macrolides: azithromycin and clarithromycin." Infect Dis Clin North Am 9 (1995): 731-45
  3. Hopkins S "Clinical toleration and safety of azithromycin." Am J Med 91 (1991): s41-5
  4. Chave J, Munafo A, Chatton JY, Dayer P, Glauser MP, Biollaz J "Once-a-week azithromycin in AIDS patients: tolerability, kinetics, and effects on zidovudine disposition." Antimicrob Agents Chemother 36 (1992): 1013-18
View all 4 references
Moderate

Macrolide antibiotics (applies to azithromycin/trovafloxacin) myasthenia gravis

Moderate Potential Hazard, Moderate plausibility.

The use of macrolide antibiotics has been reported to exacerbate symptoms of myasthenia gravis and trigger new onset of symptoms of myasthenic syndrome. Limited data suggest presynaptic suppression of acetylcholine release. Therapy with these agents should be administered cautiously in patients with a history of myasthenia gravis.

References

  1. May EF, Calvert PC "Aggravation of myasthenia gravis by erythromycin." Ann Neurol 28 (1990): 577-9
  2. "Product Information. Ery-tab (erythromycin)." Abbott Pharmaceutical, Abbott Park, IL.

Azithromycin / trovafloxacin drug interactions

There are 525 drug interactions with azithromycin / trovafloxacin

Azithromycin / trovafloxacin alcohol/food interactions

There are 2 alcohol/food interactions with azithromycin / trovafloxacin

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.