Dirithromycin Disease Interactions
There are 3 disease interactions with dirithromycin:
Macrolide Antibiotics (Includes Dirithromycin) ↔ Qt Prolongation
Severe Potential Hazard, High plausibility
Applies to: Long QT Syndrome, 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.
Antibiotics (Includes Dirithromycin) ↔ 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
- Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
- Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
- Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
Dirithromycin (Includes Dirithromycin) ↔ Liver Disease
Moderate Potential Hazard, Moderate plausibility
Applies to: Biliary Obstruction, Liver Disease
Dirithromycin is primarily excreted by the liver into the bile. Although the drug is generally well-tolerated and associated with few adverse effects, therapy with dirithromycin should be administered cautiously in patients with liver and/or biliary disease. Dosage adjustments may be appropriate in patients with severe liver disease (Child's Grade B or greater).
References
- Brogden RN, Peters DH "Dirithromycin. A review of its antimicrobial activity, pharmacokinetic properties and therapeutic efficacy." Drugs 48 (1994): 599-616
- "Product Information. Dynabac (dirithromycin)." Lilly, Eli and Company, Indianapolis, IN.
- LaBreque D, Johlin F, Janda R, Shreves T, Gereats D, DeSante K, Cerimele B, Lanier T, Sides G "Pharmacokinetics of dirithromycin in patients with impaired hepatic function." J Antimicrob Chemother 32 (1993): 741-50
dirithromycin drug Interactions
There are 63 drug interactions with dirithromycin
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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