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Drug Interactions between Aldactazide and eravacycline

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

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Interactions between your drugs

Moderate

hydroCHLOROthiazide eravacycline

Applies to: Aldactazide (hydrochlorothiazide / spironolactone) and eravacycline

MONITOR: The coadministration of diuretics with tetracyclines may result in decreased renal function and abnormalities in electrolytes and acid-base balance. As a class, tetracyclines can cause anti-anabolic effects which have led to increased blood urea nitrogen (BUN), azotemia, acidosis, and hyperphosphatemia. Diuretics have the potential to cause electrolyte and metabolic abnormalities, as well as worsen renal function. When used together, it is possible that these two classes of medications could have additive adverse effects.

MANAGEMENT: Patients on concomitant therapy with tetracycline antibiotics and diuretics should have their renal function and electrolytes monitored closely. The risk of additive adverse effects on the patient's renal function, electrolytes, and acid-base balance differs depending on the type of diuretic being used, the specific tetracycline antibiotic, and the clinical status of the patient. The manufacturer's labeling should be consulted for more specific recommendations.

References

  1. Jick H, Slone D, Shapiro S, et al. (1972) "Tetracycline and drug-attributed rises in blood urea nitrogen: a report from the Boston Collaborative Drug Surveillance Program." JAMA, 220, p. 377-9
  2. Garty M, Hurwitz A (1980) "Effect of cimetidine and antacids on gastrointestinal absorption of tetracycline." Clin Pharmacol Ther, 28, p. 203-7
  3. Tannenberg AM (1972) "Tetracycline and rises in urea nitrogen." JAMA, 221, p. 713
  4. Alexander MR (1972) "Tetracycline and rises in urea nitrogen." JAMA, 221, p. 713-4
  5. (2022) "Product Information. Xerava (eravacycline)." PAION Deutschland GmbH
  6. (2021) "Product Information. Xerava (eravacycline)." Tetraphase Pharmaceuticals, Inc
  7. (2022) "Product Information. Ospolot (sulthiame)." Phebra Pty Ltd, 10
  8. (2022) "Product Information. AcetaZOLAMIDE (acetaZOLAMIDE)." Mylan Institutional (formerly UDL Laboratories)
  9. (2021) "Product Information. AMILoride Hydrochloride (aMILoride)." Padagis
  10. (2020) "Product Information. Spironolactone (spironolactone)." Amneal Pharmaceuticals
  11. (2022) "Product Information. Kerendia (finerenone)." Bayer Pharmaceutical Inc
  12. (2021) "Product Information. Eplerenone (eplerenone)." Westminster Pharmaceuticals LLC
View all 12 references

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Moderate

spironolactone eravacycline

Applies to: Aldactazide (hydrochlorothiazide / spironolactone) and eravacycline

MONITOR: The coadministration of diuretics with tetracyclines may result in decreased renal function and abnormalities in electrolytes and acid-base balance. As a class, tetracyclines can cause anti-anabolic effects which have led to increased blood urea nitrogen (BUN), azotemia, acidosis, and hyperphosphatemia. Diuretics have the potential to cause electrolyte and metabolic abnormalities, as well as worsen renal function. When used together, it is possible that these two classes of medications could have additive adverse effects.

MANAGEMENT: Patients on concomitant therapy with tetracycline antibiotics and diuretics should have their renal function and electrolytes monitored closely. The risk of additive adverse effects on the patient's renal function, electrolytes, and acid-base balance differs depending on the type of diuretic being used, the specific tetracycline antibiotic, and the clinical status of the patient. The manufacturer's labeling should be consulted for more specific recommendations.

References

  1. Jick H, Slone D, Shapiro S, et al. (1972) "Tetracycline and drug-attributed rises in blood urea nitrogen: a report from the Boston Collaborative Drug Surveillance Program." JAMA, 220, p. 377-9
  2. Garty M, Hurwitz A (1980) "Effect of cimetidine and antacids on gastrointestinal absorption of tetracycline." Clin Pharmacol Ther, 28, p. 203-7
  3. Tannenberg AM (1972) "Tetracycline and rises in urea nitrogen." JAMA, 221, p. 713
  4. Alexander MR (1972) "Tetracycline and rises in urea nitrogen." JAMA, 221, p. 713-4
  5. (2022) "Product Information. Xerava (eravacycline)." PAION Deutschland GmbH
  6. (2021) "Product Information. Xerava (eravacycline)." Tetraphase Pharmaceuticals, Inc
  7. (2022) "Product Information. Ospolot (sulthiame)." Phebra Pty Ltd, 10
  8. (2022) "Product Information. AcetaZOLAMIDE (acetaZOLAMIDE)." Mylan Institutional (formerly UDL Laboratories)
  9. (2021) "Product Information. AMILoride Hydrochloride (aMILoride)." Padagis
  10. (2020) "Product Information. Spironolactone (spironolactone)." Amneal Pharmaceuticals
  11. (2022) "Product Information. Kerendia (finerenone)." Bayer Pharmaceutical Inc
  12. (2021) "Product Information. Eplerenone (eplerenone)." Westminster Pharmaceuticals LLC
View all 12 references

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Drug and food interactions

Moderate

hydroCHLOROthiazide food

Applies to: Aldactazide (hydrochlorothiazide / spironolactone)

MONITOR: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.

MANAGEMENT: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.

References

  1. Sternbach H (1991) "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol, 11, p. 390-1
  2. Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA (1984) "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med, 101, p. 498-9
  3. Feder R (1991) "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry, 52, p. 139
  4. Ellison JM, Milofsky JE, Ely E (1990) "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry, 51, p. 385-6
  5. Rodriguez de la Torre B, Dreher J, Malevany I, et al. (2001) "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit, 23, p. 435-40
  6. Cerner Multum, Inc. "Australian Product Information."
  7. Pacher P, Kecskemeti V (2004) "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des, 10, p. 2463-75
  8. Andrews C, Pinner G (1998) "Postural hypotension induced by paroxetine." BMJ, 316, p. 595
View all 8 references

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Moderate

spironolactone food

Applies to: Aldactazide (hydrochlorothiazide / spironolactone)

MONITOR: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.

MANAGEMENT: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.

References

  1. Sternbach H (1991) "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol, 11, p. 390-1
  2. Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA (1984) "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med, 101, p. 498-9
  3. Feder R (1991) "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry, 52, p. 139
  4. Ellison JM, Milofsky JE, Ely E (1990) "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry, 51, p. 385-6
  5. Rodriguez de la Torre B, Dreher J, Malevany I, et al. (2001) "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit, 23, p. 435-40
  6. Cerner Multum, Inc. "Australian Product Information."
  7. Pacher P, Kecskemeti V (2004) "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des, 10, p. 2463-75
  8. Andrews C, Pinner G (1998) "Postural hypotension induced by paroxetine." BMJ, 316, p. 595
View all 8 references

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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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