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Dicloxacillin Disease Interactions

There are 4 disease interactions with dicloxacillin:

Major

Antibiotics (Includes dicloxacillin) ↔ colitis

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

Penicillinase-resistant PCNs (Includes dicloxacillin) ↔ marrow toxicity

Severe Potential Hazard, Moderate plausibility. Applies to: Neutropenia, Thrombocytopenia

The use of penicillinase-resistant penicillins has been associated with adverse hematologic effects, including neutropenia, leukopenia, granulocytopenia and thrombocytopenia, particularly when given in high parenteral dosages. Agranulocytosis and prolonged bleeding time have been reported rarely. Therapy with penicillinase-resistant penicillins should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow depression, and hematopoietic function should be monitored. Blood counts with differential should be performed prior to initiation of therapy and 1 to 3 times weekly during therapy. Hematologic abnormalities are generally reversible and resolve within several days to two weeks following discontinuation of therapy.

References

  1. "Product Information. Staphcillin (methicillin)." Apothecon Inc, Plainsboro, NJ.
  2. Leventhal JM, Silken AB "Oxacillin-induced neutropenia in children." J Pediatr 89 (1976): 769-71
  3. "Product Information. Dynapen (dicloxacillin)." Apothecon Inc, Plainsboro, NJ.
  4. Brook I "Leukopenia and granulocytopenia after oxacillin therapy." South Med J 70 (1977): 565-6
  5. Slovick FT, Bamberger DM, Stark KR "Spontaneous clostridial myonecrosis in a man with drug-induced agranulocytosis." South Med J 82 (1989): 1272-4
  6. Carpenter J "Neutropenia induced by semisynthetic penicillin." South Med J 73 (1980): 745-8
  7. Clotet B, Vea AM, Rubies-Prat J, Sala MF "Cloxacillin-induced leukopenia." Arch Intern Med 145 (1985): 1531
  8. Klein JO, Finland M "The new penicillins (concluded)." N Engl J Med 269 (1963): 1129-34
  9. Kitzing W, Nelson JD, Mohs E "Comparative toxicities of methicillin and nafcillin." Am J Dis Child 135 (1981): 52-5
  10. Olaison L, Alestig K "A prospective study of neutropenia induced by high doses of B-lactam antiobiotics." J Antimicrob Chemother 25 (1990): 449-53
  11. Ahern MJ, Hicks JE, Andriole VT "Neutropenia during high dose intravenous oxacillin therapy." Yale J Biol Med 49 (1976): 351-60
  12. Jeter EK, Scott A, Kizer J, Lazarchick J "Impaired platelet function associated with parenteral nafcillin." Ann Clin Lab Sci 20 (1990): 79-84
  13. Chu JY, O'Connor DM, Schmidt RR "The mechanism of oxacillin-induced neutropenia." J Pediatr 90 (1977): 668-9
  14. Alexander DP, Russo ME, Fohrman DE, Rothstein G "Nafcillin-induced platelet dysfunction and bleeding." Antimicrob Agents Chemother 23 (1983): 59-62
  15. "Product Information. Unipen (nafcillin)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  16. Kahn JB "Oxacillin-induced agranulocytosis." JAMA 240 (1978): 2632
  17. Godin M, Deshayes P, Ducastelle T, Delpech A, Leloet X, Fillastre JP "Agranulocytosis, haemorrhagic cystitis and acute interstitial nephritis during methicillin therapy." J Antimicrob Chemother 6 (1980): 296-7
  18. Couchonnal GJ, Hinthorn DR, Hodges GR, Liu C "Nafcillin-associated granulocytopenia." South Med J 71 (1978): 1356-8
  19. "Product Information. Tegopen (cloxacillin)." Apothecon Inc, Plainsboro, NJ.
  20. "Product Information. Bactocill (oxacillin)." SmithKline Beecham, Philadelphia, PA.
  21. Neftel K, Muller MR, Hauser SP, Walti M, de Weck AL "More on penicillin-induced leukopenia." N Engl J Med 308 (1983): 901-2
  22. Greene GR, Cohen E "Nafcillin-induced neutropenia in children." Pediatrics 61 (1978): 94-7
  23. Shah I, Kumar KS, Lerner AM "Agranulocytosis associated with chronic oral administration of cloxacillin for suppression of staphylococcal osteomyelitis." Am J Hematol 12 (1982): 203-6
  24. Passoff TL, Sherry HS "Oxacillin induced neutropenia. A case report." Clin Orthop 135 (1978): 69-70
  25. Alexander DP, Russo ME, Fohrman DE, Rothstein G "Nafcillin-induced platelet dysfunction and bleeding." Antimicrob Agents Chemother 23 (1983): 59-62
  26. Westerman EL, Bradshaw MW, Williams TW "Agranulocytosis during therapy with orally administered cloxacillin." Am J Clin Pathol 69 (1978): 559-60
  27. Carpenter J "Neutropenia induced by semisynthetic penicillin." South Med J 73 (1980): 745-8
  28. Fallon JA, Tall AR, Janis MG, Brauer MJ "Oxacillin-induced granulocytopenia." Acta Haematol 59 (1978): 163-70
  29. Walbroehl GS, John PG "Antibiotic-associated neutropenia." Am Fam Physician 45 (1992): 2237-41
View all 29 references
Moderate

Diclox-methacillin (Includes dicloxacillin) ↔ cystic fibrosis

Moderate Potential Hazard, High plausibility. Applies to: Cystic Fibrosis

The penicillinase-resistant penicillins, dicloxacillin and methicillin, are both eliminated by the kidney. Renal elimination of these penicillins has been shown to increase in patients with cystic fibrosis, resulting in decreased peak serum drug concentrations and AUCs. Clinicians should be cognizant of these effects when prescribing or administering the antibiotics to patients with cystic fibrosis.

References

  1. "Product Information. Staphcillin (methicillin)." Apothecon Inc, Plainsboro, NJ.
  2. "Product Information. Dynapen (dicloxacillin)." Apothecon Inc, Plainsboro, NJ.
  3. Yaffe SJ, Gerbracht LM, Mosovich LL, Mattar ME, Danish M, Jusko WJ "Pharmacokinetics of methicillin in patients with cystic fibrosis." J Infect Dis 135 (1977): 828-31
Moderate

Dicloxacillin (Includes dicloxacillin) ↔ sodium

Moderate Potential Hazard, High plausibility. Applies to: Congestive Heart Failure, Fluid Retention, Hypernatremia, Hypertension

Each 250 mg capsule of dicloxacillin sodium contains approximately 14 mg (0.6 mEq) of sodium, and each teaspoonful of the 62.5 mg/5 mL oral suspension contains approximately 67 mg (2.9 mEq) of sodium. The sodium content should be considered in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.

References

  1. "Product Information. Dynapen (dicloxacillin)." Apothecon Inc, Plainsboro, NJ.

Dicloxacillin drug interactions

There are 63 drug interactions with dicloxacillin

Dicloxacillin alcohol/food interactions

There are 2 alcohol/food interactions with dicloxacillin

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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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