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Drug Interactions between Alprazolam Intensol and cefotetan

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

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Interactions between your drugs

No interactions were found between Alprazolam Intensol and cefotetan. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Alprazolam Intensol

A total of 549 drugs are known to interact with Alprazolam Intensol.

cefotetan

A total of 39 drugs are known to interact with cefotetan.

Drug and food interactions

Moderate

ALPRAZolam food

Applies to: Alprazolam Intensol (alprazolam)

GENERALLY AVOID: The pharmacologic activity of oral midazolam, triazolam, and alprazolam may be increased if taken after drinking grapefruit juice. The proposed mechanism is CYP450 3A4 enzyme inhibition. In addition, acute alcohol ingestion may potentiate CNS depression and other CNS effects of many benzodiazepines. Tolerance may develop with chronic ethanol use. The mechanism may be decreased clearance of the benzodiazepines because of CYP450 hepatic enzyme inhibition. Also, it has been suggested that the cognitive deficits induced by benzodiazepines may be increased in patients who chronically consume large amounts of alcohol.

MANAGEMENT: The manufacturer recommends that grapefruit juice should not be taken with oral midazolam. Patients taking triazolam or alprazolam should be monitored for excessive sedation. Alternatively, the patient could consume orange juice which does not interact with these drugs. Patients should be advised to avoid alcohol during benzodiazepine therapy.

References

  1. (2002) "Product Information. Xanax (alprazolam)." Pharmacia and Upjohn
  2. (2002) "Product Information. Valium (diazepam)." Roche Laboratories
  3. (2001) "Product Information. Halcion (triazolam)." Pharmacia and Upjohn
  4. (1995) "Grapefruit juice interactions with drugs." Med Lett Drugs Ther, 37, p. 73-4
  5. Kupferschmidt HHT, Ha HR, Ziegler WH, Meier PJ, Krahenbuhl S (1995) "Interaction between grapefruit juice and midazolam in humans." Clin Pharmacol Ther, 58, p. 20-8
  6. Hukkinen SK, Varhe A, Olkkola KT, Neuvonen PJ (1995) "Plasma concentrations of triazolam are increased by concomitant ingestion of grapefruit juice." Clin Pharmacol Ther, 58, p. 127-31
  7. Bailey DG, Dresser GR, Kreeft JH, Munoz C, Freeman DJ, Bend JR (2000) "Grapefruit-felodipine interaction: Effect of unprocessed fruit and probable active ingredients." Clin Pharmacol Ther, 68, p. 468-77
View all 7 references

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Moderate

cefoTEtan food

Applies to: cefotetan

GENERALLY AVOID: Some cephalosporins may occasionally induce a disulfiram-like reaction when coadministered with alcohol. The interaction has been reported for cefamandole, cefoperazone, cefotetan, and moxalactam. These agents contain an N-methylthiotetrazole (NMTT) side chain that may inhibit aldehyde dehydrogenase (ALDH) similar to disulfiram. Following ingestion of alcohol, inhibition of ALDH results in increased concentration of acetaldehyde, the accumulation of which produces an unpleasant physiologic response referred to as the 'disulfiram reaction'. Symptoms include flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, weakness, vertigo, blurred vision, and confusion. Severe reactions may result in respiratory depression, cardiovascular collapse, arrhythmias, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death. Cefonicid contains a structurally similar side chain but did not produce elevations in blood acetaldehyde or a disulfiram reaction to ethanol in 15 healthy volunteers given single and multiple one gram doses of the drug.

MANAGEMENT: Patients receiving cephalosporins with the NMTT side chain should avoid the concomitant use of alcohol and alcohol-containing products.

References

  1. Kline SS, Mauro VF, Forney RB Jr, et al. (1987) "Cefotetan-induced disulfiram-type reactions and hypoprothrombinemia." Antimicrob Agents Chemother, 31, p. 1328-31
  2. Freundt KJ, Kitson TM (1986) "Inactivation of aldehyde dehydrogenase by a putative metabolite of cefamandole." Infection, 14, p. 44-7
  3. Freundt KJ, Schreiner E, Christmann-Kleiss U (1985) "Cefamandole: a competitive inhibitor of aldehyde dehydrogenase." Infection, 13, p. 91
  4. McMahon FG (1980) "Disulfiram-like reaction to a cephalosporin." JAMA, 243, p. 2397
  5. Reeves DS, Davies AJ (1980) "Antabuse effect with cephalosporins." Lancet, 2, p. 540
  6. Brown KR, Guglielmo BJ, Pons VG, Jacobs RA (1982) "Theophylline elixir, moxalactam, and a disulfiram reaction." Ann Intern Med, 97, p. 621-2
  7. Umeda S, Arai T (1985) "Disulfiram-like reaction to moxalactam after celiac plexus alcohol block." Anesth Analg, 64, p. 377
  8. Foster TS, Raehl CL, Wilson HD (1980) "Disulfiram-like reaction associated with a parenteral cephalosporin." Am J Hosp Pharm, 37, p. 858-9
  9. McMahon FG, Ryan JR, Jain AK, LaCorte W, Ginzler F (1987) "Absence of disulfiram-type reactions to single and multiple doses of cefonicid: a placebo-controlled study." J Antimicrob Chemother, 20, p. 913-8
View all 9 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.

See also

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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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