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Dalbavancin Disease Interactions

There are 3 disease interactions with dalbavancin:

Major

Antibiotics (applies to dalbavancin) 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

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  11. Miller DL, Sedlack JD, Holt RW "Perforation complicating rifampin-associated pseudomembranous enteritis." Arch Surg 124 (1989): 1082
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View all 47 references
Moderate

Dalbavancin (applies to dalbavancin) liver disease

Moderate Potential Hazard, Moderate plausibility.

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 (applies to dalbavancin) renal dysfunction

Moderate Potential Hazard, High plausibility.

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 7 drug interactions with dalbavancin

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.