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Drug Interactions between A-25 and eravacycline

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

vitamin A eravacycline

Applies to: A-25 (vitamin a) and eravacycline

MONITOR CLOSELY: Concomitant use of vitamin A or related compounds (i.e., retinoids) with tetracyclines may increase the risk of pseudotumor cerebri, also known as benign intracranial hypertension. These agents individually have been associated with the development of pseudotumor cerebri and may have additive effects during coadministration. The interaction has been suspected in reported cases involving the use of isotretinoin or vitamin A in combination with a tetracycline. Other vitamin A-related compounds may interact similarly. Both acute and chronic vitamin A intoxication have been identified as secondary causes of pseudotumor cerebri.

MANAGEMENT: Caution is advised if vitamin A is coadministered with tetracyclines. Concomitant use of most retinoids (vitamin A derivatives) with tetracyclines is considered contraindicated. Patients should be counseled to contact their healthcare provider immediately if they develop signs or symptoms of pseudotumor cerebri such as papilledema, headache, nausea, vomiting, and/or visual disturbances. The patient should be advised to discontinue vitamin A and the tetracycline and be referred for immediate neurological evaluation and care if pseudotumor cerebri is suspected as this could result in permanent vision loss.

References (23)
  1. Walters BN, Gubbay SS (1981) "Tetracycline and benign intracranial hypertension: report of five cases." Br Med J, 282, p. 19-20
  2. Minutello JS, Dimayuga RG, Carter J (1988) "Pseudotumor cerebri, a rare adverse reaction to tetracycline therapy." J Periodontol, 59, p. 848-51
  3. Delaney RA, Narayanaswamy TR (1990) "Pseudo-tumor cerebri and acne." Mil Med, 155, p. 511
  4. Donnet A, Dufour H, Graziani N, Grisoli F (1992) "Minocycline and benign intracranial hypertension." Biomed Pharmacother, 46, p. 171-2
  5. (2001) "Product Information. Achromycin (tetracycline)." Lederle Laboratories
  6. Yokokura M, Hatake K, Komatsu N, Kajitani H, Miura Y (1994) "Toxicity of tretinoin in acute promyelocytic leukaemia." Lancet, 343, p. 361-2
  7. Schmitt K, Schwarz R, Tulzer G, Krieger O, Zoubek A, Gadner H (1994) "Toxicity of tretinoin in acute promyelocytic leukaemia." Lancet, 343, p. 361
  8. (2001) "Product Information. Accutane (isotretinoin)." Roche Laboratories
  9. Gardner K, Cox T, Digre KB (1995) "Idiopathic intracranial hypertension associated with tetracycline use in fraternal twins: case reports and review." Neurology, 45, p. 6-10
  10. Cuddihy J (1994) "Case report of benign intercranial hypertension secondary to tetracycline." Ir Med J, 87, p. 90
  11. Lee AG (1995) "Pseudotumor cerebri after treatment with tetracycline and isotretinoin for acne." Cutis, 55, p. 165-8
  12. Roytman M, Frumkin A, Bohn TG (1988) "Pseudotumor cerebri caused by isotretinoin." Cutis, 42, p. 399-400
  13. Lewis PA, Kearney PJ (1997) "Pseudotumor cerebri induced by minocycline treatment for acne vulgaris." Acta Derm Venereol, 77, p. 83
  14. (2001) "Product Information. Soriatane (acitretin)." Roche Laboratories
  15. Chiu AM, Chuenkongkaew WL, Cornblath WT, Trobe JD, Digre KB, Dotan SA, Musson KH, Eggenberger ER (1998) "Minocycline treatment and pseudotumor cerebri syndrome." Am J Ophthalmol, 126, p. 116-21
  16. (2001) "Product Information. Vesanoid (tretinoin)." Roche Laboratories
  17. Weese-Mayer DE, Yang RJ, Mayer JR, Zaparackas Z (2001) "Minocycline and Pseudotumor cerebri: The well-known but well-kept secret." Pediatrics, 108, p. 519-20
  18. Moskowitz Y, Leibowitz E, Ronen M, Aviel E (1993) "Pseudotumor cerebri induced by vitamin A combined with minocycline." Ann Ophthalmol, 25, p. 306-8
  19. Chan AY, Liu DT, Friedman DI, Gordon LK, Egan RA (2005) "Doxycycline and intracranial hypertension." Neurology, 64, p. 765-6
  20. Tabibian JH, Gutierrez MA (2009) "Doxycycline-induced pseudotumor cerebri." South Med J, 102, p. 310-1
  21. (2018) "Product Information. Seysara (sarecycline)." Allergan Inc
  22. Gasparian S, Geng X, Hawy E (2021) "Intracranial hypertension associated with topical tretinoin use." Am J Ophthalmol Case Rep, 23, p. 101130
  23. Tor Generics Limited (2023) Retinol and colecalciferol 4500 IU/450 IU soft gel capsules (vitamin a & d). https://www.medicines.org.uk/emc/product/11767/smpc

Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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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

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