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Dalbavancin Disease Interactions

There are 3 disease interactions with dalbavancin:

Moderate

Antibiotics (Includes Dalbavancin) ↔ Colitis

Moderate Potential Hazard, Moderate plausibility

Applies to: 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. Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
View all 47 references
Moderate

Dalbavancin (Includes Dalbavancin) ↔ Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Dalbavancin is partially metabolized by the liver. In a study of patients with varying degrees of liver impairment given dalbavancin, the mean systemic exposure (AUC) was unchanged in subjects with mild hepatic impairment (Child-Pugh class A), but decreased 28% and 31% in subjects with moderate and severe hepatic impairment (Child-Pugh class B and C), respectively, compared to subjects with normal hepatic function. The clinical significance of these changes is unknown. Therapy with dalbavancin should be administered cautiously in patients with moderate or severe hepatic impairment, as no data are available to determine the appropriate dosing in these patients.

Moderate

Dalbavancin (Includes Dalbavancin) ↔ Renal Dysfunction

Moderate Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Dalbavancin is primarily eliminated by the kidney. In a study of patients with varying degrees of renal impairment, the mean plasma clearance of dalbavancin following a single 500 mg or 1000 mg dose was reduced by 11%, 35%, and 47% in subjects with mild (CrCl 50 to 79 mL/min), moderate (CrCl 30 to 49 mL/min), and severe (CrCl less than 30 mL/min) renal impairment, respectively, compared to subjects with normal renal function. The clinical significance of these decreases and the associated increase in systemic exposure (AUC) noted in subjects with severe renal impairment has not been established. No dosage adjustment is necessary for patients with CrCl greater than 30 mL/min or for patients receiving hemodialysis. The recommended two-dose regimen in patients with severe renal impairment who are not receiving regularly scheduled hemodialysis is 750 mg once, followed by 375 mg one week later. Dalbavancin pharmacokinetic parameters in subjects with end-stage renal disease receiving hemodialysis three times per week were similar to those observed in subjects with mild to moderate renal impairment, and less than 6% of an administered dose was removed after three hours of hemodialysis. Therefore, no dosage adjustment is recommended for patients receiving regularly scheduled hemodialysis, and dalbavancin may be administered without regard to the timing of hemodialysis.

dalbavancin drug Interactions

There are 18 drug interactions with dalbavancin

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.

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

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