Skip to Content

Bismuth subcitrate potassium / metronidazole / tetracycline Disease Interactions

There are 10 disease interactions with bismuth subcitrate potassium / metronidazole / tetracycline:

Major

Nitroimidazoles (Includes Bismuth subcitrate potassium/metronidazole/tetracycline) ↔ Blood Dyscrasias

Severe Potential Hazard, Low plausibility

Applies to: History - Blood Dyscrasias, Bone Marrow Depression/Low Blood Counts

The use of nitroimidazoles (e.g., metronidazole, tinidazole) has rarely been associated with hematologic adverse effects such as mild, transient leukopenia, thrombocytopenia, and bone marrow aplasia. The manufacturers recommend that therapy with nitroimidazoles be administered cautiously in patients with evidence of or a history of blood dyscrasias, and that total and differential leukocyte counts be performed before and after treatment with these drugs, particularly in patients receiving repeated courses of therapy.

References

  1. White CM, Price JJ, Hunt KM "Bone marrow aplasia associated with metronidazole." Br Med J 280 (1980): 647
  2. "Product Information. Tindamax (tinidazole)." Presutti Laboratories Inc, Arlington Heights, IL.
  3. "Product Information. Flagyl (metronidazole)." Searle, Skokie, IL.
  4. Smith JA "Neutropenia associated with metronidazole therapy." Can Med Assoc J 123 (1980): 202
View all 4 references
Major

Nitroimidazoles (Includes Bismuth subcitrate potassium/metronidazole/tetracycline) ↔ Neurologic Toxicity

Severe Potential Hazard, Moderate plausibility

Applies to: CNS Disorder, Peripheral Neuropathy

The use of nitroimidazoles (e.g., metronidazole, tinidazole) has been associated with the development of nervous system toxicity including convulsive seizures and dose-related peripheral neuropathy, the latter characterized primarily by numbness or paresthesia of an extremity. Persistent peripheral neuropathy has been reported in some patients treated for prolonged periods. Other neurologic adverse effects include vertigo, incoordination, ataxia, confusion, agitation, hallucinations, and depression. Therapy with nitroimidazoles should be administered cautiously in patients with or predisposed to seizures or other nervous system abnormalities. Nitroimidazole therapy should be discontinued promptly if neurologic disturbances occur.

References

  1. "Product Information. Tindamax (tinidazole)." Presutti Laboratories Inc, Arlington Heights, IL.
  2. Learned-Coughlin S "Peripheral neuropathy induced by metronidazole." Ann Pharmacother 28 (1994): 536
  3. Lawford R, Sorrell TC "Amebic abscess of the spleen complicated by metronidazole-induced neurotoxicity: case report." Clin Infect Dis 19 (1994): 346-8
  4. Wienbren M, Perinpanayagam RM, Camba L, Lee CA "Convulsions and encephalopathy in a patient with leukaemia after treatment with metronidazole." J Clin Pathol 38 (1985): 1076
  5. Kusumi RK, Plouffe JF, Wyatt RH, Fass RJ "Central nervous sytem toxicity associated with metronidazole therapy." Ann Intern Med 93 (1980): 59-60
  6. "Product Information. Flagyl (metronidazole)." Searle, Skokie, IL.
  7. Schreiber W, Spernal J "Metronidazole-induced psychotic disorder." Am J Psychiatry 154 (1997): 1170-1
  8. Alvarez RS, Richardson DA, Bent AE, Ostergard DR "Central nervous system toxicity related to prolonged metronidazole therapy." Am J Obstet Gynecol 145 (1983): 640-1
  9. Stahlberg D, Barany F, Einarsson K, Ursing B, Elmquist D, Persson A "Neurophysiologic studies of patients with Crohn's disease on long-term treatment with metronidazole." Scand J Gastroenterol 26 (1991): 219-24
  10. Duffy LF, Daum F, Fisher SE, et al "Peripheral neuropathy in Crohn's disease patients treated with metronidazole." Gastroenterology 88 (1985): 681-4
  11. Boyce EG, Cookson ET, Bond WS "Persistent metronidazole-induced peripheral neuropathy." DICP 24 (1990): 19-21
  12. Schentag JJ, Ziemniak JA, Greco JM, Rainstein M, Buckley RJ "Mental confusion in a patient treated with metronidazole: a concentration-related effect." Pharmacotherapy 2 (1982): 384-7
  13. Beloosesky Y, Grosman B, Marmelstein V, Grinblat J "Convulsions induced by metronidazole treatment for Clostridium difficile-associated disease in chronic renal failure." Am J Med Sci 319 (2000): 338-9
  14. Ahmed A, Laes DJ, Bressler EL "Reversible magnetic resonance imaging findings in metronidazole-induced encephalopathy." Neurology 45 (1995): 588-9
View all 14 references
Moderate

Antibiotics (Includes Bismuth subcitrate potassium/metronidazole/tetracycline) ↔ Colitis

Moderate Potential Hazard, Moderate plausibility

Applies to: Colitis/Enteritis (Noninfectious), Colitis/Enteritis (Noninfectious)

Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to two months following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic- associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.

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. Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
  3. Davies J, Beck E "Recurrent colitis following antibiotic-associated pseudomembranous colitis." Postgrad Med J 57 (1981): 599-601
  4. Bauwens JE, McFarland LV, Melcher SA "Recurrent clostridium difficile disease following ciprofloxacin use." Ann Pharmacother 31 (1997): 1090
  5. Dan M, Samra Z "Clostridium difficile colitis associated with ofloxacin therapy." Am J Med 87 (1989): 479
  6. Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
  7. Milstone EB, McDonald AJ, Scholhamer CF Jr "Pseudomembranous colitis after topical application of clindamycin." Arch Dermatol 117 (1981): 154-5
  8. 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
  9. Cone JB, Wetzel W "Toxic megacolon secondary to pseudomembranous colitis." Dis Colon Rectum 25 (1982): 478-82
  10. 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
  11. Saadah HA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 93 (1980): 645
  12. 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
  13. Miller SN, Ringler RP "Vancomycin-induced pseudomembranous colitis." J Clin Gastroenterol 9 (1987): 114-5
  14. 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
  15. Miller DL, Sedlack JD, Holt RW "Perforation complicating rifampin-associated pseudomembranous enteritis." Arch Surg 124 (1989): 1082
  16. Trexler MF, Fraser TG, Jones MP "Fulminant pseudomembranous colitis caused by clindamycin phosphate vaginal cream." Am J Gastroenterol 92 (1997): 2112-3
  17. Daly JJ, Chowdary KV "Pseudomembranous colitis secondary to metronidazole." Dig Dis Sci 28 (1983): 573-4
  18. Lyon JA "Imipenem/cilastatin: the first carbapenem antibiotic." Drug Intell Clin Pharm 19 (1985): 894-8
  19. Hutcheon DF, Milligan FD, Yardley JH, Hendrix TR "Cephalosporin-associated pseudomembranous colitis." Am J Dig Dis 23 (1978): 321-6
  20. Bingley PJ, Harding GM "Clostridium difficile colitis following treatment with metronidazole and vancomycin." Postgrad Med J 63 (1987): 993-4
  21. 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
  22. O'Meara TF, Simmons RA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 92 (1980): 440-1
  23. Meadowcroft AM, Diaz PR, Latham GS "Clostridium difficile toxin-induced colitis after use of clindmycin phosphate vaginal cream." Ann Pharmacother 32 (1998): 309-11
  24. Sankarankutty M, McGeorge D, Galasko CS "Pseudomembranous colitis following cephradine prophylaxis." Postgrad Med J 58 (1982): 726-8
  25. Bernstein L "Adverse reaction to trimethoprim-sulfamethoxazole, with particular reference to long-term therapy." Can Med Assoc J 112 (1975): s96-8
  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. 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
  28. Altamirano A, Bondani A "Adverse reactions to furazolidone and other drugs. A comparative review." Scand J Gastroenterol Suppl 169 (1989): 70-80
  29. Ehrenpreis ED, Lievens MW, Craig RM "Clostridium difficile-associated diarrhea after norfloxacin." J Clin Gastroenterol 12 (1990): 188-9
  30. Boriello SP, Jones RH, Phillips I "Rifampicin-associated pseudomembranous colitis." Br Med J 281 (1980): 1180-1
  31. Klinger D, Radford P, Collin J "Pneumoperitoneum without faecal peritonitis in a patient with pseudomembranous colitis." Br Med J 288 (1984): 1271-2
  32. Ring FA, Hershfield NB, Machin GA, Scott RB "Sulfasalazine-induced colitis complicating idiopathic ulcerative colitis." Can Med Assoc J 131 (1984): 43-5
  33. Friedman RJ, Mayer IE, Galambos JT, Hersh T "Oxacillin-induced pseudomembranous colitis." Am J Gastroenterol 73 (1980): 445-7
  34. "Multum Information Services, Inc. Expert Review Panel"
  35. 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
  36. 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
  37. 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
  38. 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
  39. Parry MF, Rha CK "Pseudomembranous colitis caused by topical clindamycin phosphate." Arch Dermatol 122 (1986): 583-4
  40. 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
  41. Hecht JR, Olinger EJ "Clostridium difficile colitis secondary to intravenous vancomycin." Dig Dis Sci 34 (1989): 148-9
  42. 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
  43. Hinton NA "The effect of oral tetracycline HCl and doxycycline on the intestinal flora." Curr Ther Res Clin Exp 12 (1970): 341-52
  44. Saginur R, Hawley CR, Bartlett JG "Colitis associated with metronidazole therapy." J Infect Dis 141 (1980): 772-4
  45. Sugarman B "Trimethoprim-sulfamethoxazole, pseudomembranous colitis, and spinal cord injury." South Med J 78 (1985): 711-3
  46. Golledge CL, Riley TV "Clostridium difficile-associated diarrhoea after doxycycline malaria prophylaxis." Lancet 345 (1995): 1377-8
  47. 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
View all 47 references
Moderate

Metronidazole (Includes Bismuth subcitrate potassium/metronidazole/tetracycline) ↔ Alcoholism

Moderate Potential Hazard, Moderate plausibility

Applies to: Alcoholism

Nitroimidazoles (e.g., metronidazole, tinidazole) may inhibit alcohol dehydrogenase and occasionally precipitate a disulfiram-like reaction in patients who consume alcohol while being treated. Symptoms may include nausea, vomiting, flushing, sweating, headache, abdominal cramps, and hypotension. Patients should be instructed to avoid alcohol-containing products during nitroimidazole therapy and for at least 48 to 72 hours after the last dose. Therapy with nitroimidazoles should be administered cautiously in patients who might be prone to acute alcohol intake. An alternative therapy may be appropriate.

References

  1. Giannini AJ, DeFrance DT "Metronidazole and alcohol: potential for combinative abuse." J Toxicol Clin Toxicol 20 (1983): 509-15
  2. "Product Information. Flagyl (metronidazole)." Searle, Skokie, IL.
  3. Harries DP, Teale KF, Sunderland G "Metronidazole and alcohol: potential problems." Scott Med J 35 (1990): 179-80
  4. "Product Information. Tindamax (tinidazole)." Presutti Laboratories Inc, Arlington Heights, IL.
  5. Alexander I "Alcohol-antabuse syndrome in patients receiving metronidazole during gynaecological treatment." Br J Clin Pract 39 (1985): 292-3
  6. Williams CS, Woodcock KR "Do ethanol and metronidazole interact to produce a disulfiram-like reaction?." Ann Pharmacother 34 (2000): 255-7
View all 6 references
Moderate

Metronidazole (Includes Bismuth subcitrate potassium/metronidazole/tetracycline) ↔ Dialysis

Moderate Potential Hazard, High plausibility

Applies to: hemodialysis

Metronidazole and its metabolites are moderately removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.

References

  1. Kreeft JH, Ogilvie RI, Dufresne LR "Metronidazole kinetics in dialysis patients." Surgery 93 (1983): 149-53
  2. "Product Information. Flagyl (metronidazole)." Searle, Skokie, IL.
  3. Roux AF, Moirot E, Delhotal B, et al "Metronidazole kinetics in patients with acute renal failure on dialysis: a cumulative study." Clin Pharmacol Ther 36 (1984): 363-8
  4. Somogyi A, Kong C, Sabto J, Gurr FW, Spicer WJ, McLean AJ "Disposition and removal of metronidazole in patients undergoing haemodialysis." Eur J Clin Pharmacol 25 (1983): 683-7
  5. Lau AH, Chang CW, Sabatini S "Hemodialysis clearance of metronidazole and its metabolites." Antimicrob Agents Chemother 29 (1986): 235-8
View all 5 references
Moderate

Metronidazole (Includes Bismuth subcitrate potassium/metronidazole/tetracycline) ↔ Liver Disease

Moderate Potential Hazard, High plausibility

Applies to: Liver Disease

Metronidazole is extensively metabolized by the liver to both pharmacologically active and inactive compounds. The plasma clearance of metronidazole may be decreased and the half-life prolonged in patients with impaired hepatic function. Therapy with metronidazole should be administered cautiously at reduced dosages in patients with severe liver disease.

References

  1. Loft S, Dossing M, Poulsen HE, et al "Influence of dose and route of administration on disposition of metronidazole and its major metabolites." Eur J Clin Pharmacol 30 (1986): 467-73
  2. Loft S, Sonne J, Dossing M, Andreasen PB "Metronidazole pharmacokinetics in patients with hepatic encephalopathy." Scand J Gastroenterol 22 (1987): 117-23
  3. Jensen JC, Gugler R "Single- and multiple-dose metronidazole kinetics." Clin Pharmacol Ther 34 (1983): 481-7
  4. "Product Information. Flagyl (metronidazole)." Searle, Skokie, IL.
  5. Farrell G, Baird-Lambert J, Cvejic M, Buchanan N "Disposition and metabolism of metronidazole in patients with liver failure." Hepatology 4 (1984): 772-6
  6. Lau AH, Evans R, Chang CW, Seligsohn R "Pharmacokinetics of metronidazole in patients with alcoholic liver disease." Antimicrob Agents Chemother 31 (1987): 1662-4
View all 6 references
Moderate

Metronidazole (Includes Bismuth subcitrate potassium/metronidazole/tetracycline) ↔ Sodium

Moderate Potential Hazard, High plausibility

Applies to: Congestive Heart Failure, Hypertension, Fluid Retention, Hypernatremia

Flagyl I.V. RTU (brand of metronidazole ready-to-use injection) contains 14 mEq of sodium per each 500 mg dose of metronidazole. The sodium content should be considered when this product is used in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.

References

  1. "Product Information. Flagyl (metronidazole)." Searle, Skokie, IL.
Moderate

Tetracyclines (Includes Bismuth subcitrate potassium/metronidazole/tetracycline) ↔ Hepatotoxicity

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

The use of tetracyclines has rarely been associated with hepatotoxicity. Histologic fatty changes of the liver, elevated liver enzymes, and jaundice have been reported, primarily in patients treated with large doses of intravenous tetracycline hydrochloride (no longer available in the U.S.) but also in patients receiving high oral doses of these drugs. Therapy with tetracyclines should be administered cautiously in patients with preexisting liver disease or biliary obstruction. Reduced dosages may be appropriate, particularly with minocycline and doxycycline, since the former is metabolized by the liver and the latter undergoes enterohepatic recycling. Liver function tests are recommended prior to and during therapy, and the concomitant use of other potentially hepatotoxic drugs should be avoided.

References

  1. Min DI, Burke PA, Lewis D, Jenkins RL "Acute hepatic failure associated with oral minocycline: a case report." Pharmacotherapy 12 (1992): 68-71
  2. Brogden RN, Speight TM, Avery GS "Minocycline: a review of its antibacterial and pharmacokinetic properties and therapeutic use." Drugs 9 (1975): 251-91
  3. Burette A, Finet C, Prigogine T, De Roy G, Deltenre M "Acute hepatic injury associated with minocycline." Arch Intern Med 144 (1984): 1491-2
  4. Golstein PE, Deviere J, Cremer M "Acute hepatitis and drug-related lupus induced by minocycline treatment." Am J Gastroenterol 92 (1997): 143-6
  5. "Product Information. Vibramycin (doxycycline)." Pfizer US Pharmaceuticals, New York, NY.
  6. "Product Information. Declomycin (demeclocycline)." Lederle Laboratories, Wayne, NJ.
  7. Nelis HJ, De Leenheer AP "Metabolism of minocycline in humans." Drug Metab Dispos 10 (1982): 142-6
  8. "Product Information. Minocin (minocycline)." Lederle Laboratories, Wayne, NJ.
  9. Malcolm A, Heap TR, Eckstein RP, Lunzer MR "Minocycline-induced liver injury." Am J Gastroenterol 91 (1996): 1641-3
  10. "Product Information. Achromycin (tetracycline)." Lederle Laboratories, Wayne, NJ.
  11. "Product Information. Terramycin (oxytetracycline)." Pfizer US Pharmaceuticals, New York, NY.
View all 11 references
Moderate

Tetracyclines (Includes Bismuth subcitrate potassium/metronidazole/tetracycline) ↔ Renal Dysfunction

Moderate Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Tetracyclines (except doxycycline) are eliminated by the kidney to various extent. Patients with renal impairment may be at greater risk for tetracycline-associated hepatic and/or renal toxicity (increased BUN with consequent azotemia, hyperphosphatemia, and acidosis) due to decreased drug clearance. Therapy with tetracyclines should be administered cautiously at reduced dosages in patients with renal impairment. Clinical monitoring of renal and liver function is recommended, and serum tetracycline levels may be necessary during prolonged therapy.

References

  1. Braden GL, Geheb MA, Shook A, Singer I, Cox M "Demeclocycline-induced natriuresis and renal insufficiency: in vivo and in vitro studies." Am J Kidney Dis 5 (1985): 270-7
  2. Lee P, Crutch ER, Morrison RB, et al "Doxycycline: studies in normal subjects and patients with renal failure." N Z Med J 75 (1972): 355-8
  3. Reddy J "Tetracycline antibiotics should be avoided in patients with renal disease." N Z Med J 94 (1981): 396
  4. Heaney D, Eknoyan G "Minocycline and doxycycline kinetics in chronic renal failure." Clin Pharmacol Ther 24 (1978): 233-9
  5. "Product Information. Vibramycin (doxycycline)." Pfizer US Pharmaceuticals, New York, NY.
  6. "Product Information. Achromycin (tetracycline)." Lederle Laboratories, Wayne, NJ.
  7. Jonas M, Cunha BA "Minocycline." Ther Drug Monit 4 (1982): 137-45
  8. George CR, Evans RA "Tetracycline toxicity in renal failure." Med J Aust 06/12/71 (1971): 1271-3
  9. Miller PD, Linas SL, Schrier RW "Plasma demeclocycline levels and nephrotoxicity. Correlation in hyponatremic cirrhotic patients." JAMA 243 (1980): 2513-5
  10. Saivin S, Houin G "Clinical pharmacokinetics of doxycycline and minocycline." Clin Pharmacokinet 15 (1988): 355-66
  11. Carrilho F, Bosch J, Arroyo V, Mas A, Viver J, Rodes J "Renal failure associated with demeclocycline in cirrhosis." Ann Intern Med 87 (1977): 195-7
  12. "Product Information. Terramycin (oxytetracycline)." Pfizer US Pharmaceuticals, New York, NY.
  13. Whelton A, von Wittenau MS, Twomey TM, et al "Doxycycline pharmacokinetics in the absence of renal function." Kidney Int 5 (1974): 365-71
  14. Oster JR, Epstein M "Demeclocycline-induced renal failure." Lancet 1 (1977): 52
  15. Roth H, Becker KL, Shalhoub RJ, Katz S "Nephrotoxicity of demethylchlortetracycline hydrochloride. A prospective study." Arch Intern Med 120 (1967): 433-5
  16. "Product Information. Declomycin (demeclocycline)." Lederle Laboratories, Wayne, NJ.
  17. Shils ME "Renal disease and the metabolic effects of tetracycline." Ann Intern Med 58 (1963): 389-408
  18. Carney S, Butcher RA, Dawborn JK, Pattison G "Minocycline excretion and distribution in relation to renal function in man." Clin Exp Pharmacol Physiol 1 (1974): 299-308
  19. Kirkpatrick R "Demeclocycline and renal insufficiency." JAMA 239 (1978): 616
  20. Sklenar I, Spring P, Dettli L "One-dose and multiple-dose kinetics of minocycline in patients with renal disease." Agents Actions 7 (1977): 369-77
  21. Whelton A "Tetracyclines in renal insufficiency: resolution of a therapeutic dilemma." Bull N Y Acad Med 54 (1978): 223-36
  22. Houin G, Brunner F, Nebout T, et al "The effects of chronic renal insufficiency on the pharmacokinetics of doxycycline in man." Br J Clin Pharmacol 16 (1983): 245-52
  23. Letteri JM, Miraflor F, Tablante V, Siddiqi S "Doxycycline (vibramycin) in chronic renal failure." Nephron 11 (1973): 318-24
  24. "Product Information. Minocin (minocycline)." Lederle Laboratories, Wayne, NJ.
  25. Welling PG, Shaw WR, Uman SJ, Tse FL, Craig WA "Pharmacokinetics of minocycline in renal failure." Antimicrob Agents Chemother 8 (1975): 532-7
  26. Macdonald H, Kelly RG, Allen ES, et al "Pharmacokinetic studies on minocycline in man." Clin Pharmacol Ther 14 (1973): 852-61
  27. Mahon WA, Johnson GE, Endrenyi L, et al "The elimination of tritiated doxycycline in normal subjects and in patients with severely impaired renal function." Scand J Infect Dis 9 (1976): 24-31
  28. Brogden RN, Speight TM, Avery GS "Minocycline: a review of its antibacterial and pharmacokinetic properties and therapeutic use." Drugs 9 (1975): 251-91
View all 28 references
Moderate

Tetracyclines (Oral) (Includes Bismuth subcitrate potassium/metronidazole/tetracycline) ↔ Esophageal Irritation

Moderate Potential Hazard, Moderate plausibility

Applies to: Esophageal Obstruction

The use of oral tetracycline capsules and tablets has been associated with esophageal irritation and ulceration in patients who ingested the drug without sufficient fluid shortly before bedtime. Therapy with solid formulations of tetracyclines should preferably be avoided in patients with esophageal obstruction, compression or dyskinesia. If the drugs are used, patients should be advised not to take the medication just before retiring and to drink fluids liberally.

References

  1. Channer KS, Hollanders D "Tetracycline-induced oesophageal ulceration." Br Med J 282 (1981): 1359-60
  2. Nordt SP "Tetracycline-induced oral mucosal ulceration." Ann Pharmacother 30 (1996): 547-8
  3. Aarons B, Bruns BJ "Oesophageal ulceration associated with ingestion of doxycycline." N Z Med J 91 (1980): 27
  4. "Product Information. Minocin (minocycline)." Lederle Laboratories, Wayne, NJ.
  5. Amendola MA, Spera TD "Doxycycline-induced esophagitis." JAMA 253 (1985): 1009-11
  6. "Product Information. Declomycin (demeclocycline)." Lederle Laboratories, Wayne, NJ.
  7. Khera DC, Herschman BR, Sosa F "Tetracycline-induced esophageal ulcers." Postgrad Med J 68 (1980): 113-5
  8. "Product Information. Achromycin (tetracycline)." Lederle Laboratories, Wayne, NJ.
  9. Geschwind A "Oesophagitis and oesophageal ulceration following ingestion of doxycycline tablets." Med J Aust 140 (1984): 223
  10. "Product Information. Vibramycin (doxycycline)." Pfizer US Pharmaceuticals, New York, NY.
  11. Foster JA, Sylvia LM "Doxycyline-induced esophageal ulceration." Ann Pharmacother 28 (1994): 1185-7
  12. "Product Information. Terramycin (oxytetracycline)." Pfizer US Pharmaceuticals, New York, NY.
View all 12 references

bismuth subcitrate potassium / metronidazole / tetracycline drug Interactions

There are 660 drug interactions with bismuth subcitrate potassium / metronidazole / tetracycline

bismuth subcitrate potassium / metronidazole / tetracycline alcohol/food Interactions

There are 4 alcohol/food interactions with bismuth subcitrate potassium / metronidazole / tetracycline

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
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 information available.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2018 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

Hide