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Drug Interactions between amoxicillin / clarithromycin / vonoprazan and fecal microbiota spores, live

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

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Interactions between your drugs

Major

amoxicillin fecal microbiota spores, live

Applies to: amoxicillin / clarithromycin / vonoprazan and fecal microbiota spores, live

GENERALLY AVOID: Antibiotics may interfere with the therapeutic effects of oral fecal microbiota, which contains live bacterial spores. The mechanism may be related to the antibiotic inactivating the bacterial spores or reducing bacterial replication. However, the clinical significance of this interaction has not been established.

MANAGEMENT: Concomitant use of oral fecal microbiota spores with antibiotics should generally be avoided. The manufacturer of the oral formulation of fecal microbiota recommends that treatment commence two to four days after completing antibiotic treatment for Clostridium difficile infection.

References (1)
  1. (2023) "Product Information. Vowst (fecal microbiota spores, live)." Aimmune Therapeutics
Major

clarithromycin fecal microbiota spores, live

Applies to: amoxicillin / clarithromycin / vonoprazan and fecal microbiota spores, live

GENERALLY AVOID: Antibiotics may interfere with the therapeutic effects of oral fecal microbiota, which contains live bacterial spores. The mechanism may be related to the antibiotic inactivating the bacterial spores or reducing bacterial replication. However, the clinical significance of this interaction has not been established.

MANAGEMENT: Concomitant use of oral fecal microbiota spores with antibiotics should generally be avoided. The manufacturer of the oral formulation of fecal microbiota recommends that treatment commence two to four days after completing antibiotic treatment for Clostridium difficile infection.

References (1)
  1. (2023) "Product Information. Vowst (fecal microbiota spores, live)." Aimmune Therapeutics
Minor

amoxicillin clarithromycin

Applies to: amoxicillin / clarithromycin / vonoprazan and amoxicillin / clarithromycin / vonoprazan

Although some in vitro data indicate synergism between macrolide antibiotics and penicillins, other in vitro data indicate antagonism. When these drugs are given together, neither has predictable therapeutic efficacy. Data are available for erythromycin, although theoretically this interaction could occur with any macrolide. Except for monitoring of the effectiveness of antibiotic therapy, no special precautions appear to be necessary.

References (3)
  1. Strom J (1961) "Penicillin and erythromycin singly and in combination in scarlatina therapy and the interference between them." Antibiot Chemother, 11, p. 694-7
  2. Cohn JR, Jungkind DL, Baker JS (1980) "In vitro antagonism by erythromycin of the bactericidal action of antimicrobial agents against common respiratory pathogens." Antimicrob Agents Chemother, 18, p. 872-6
  3. Penn RL, Ward TT, Steigbigel RT (1982) "Effects of erythromycin in combination with penicillin, ampicillin, or gentamicin on the growth of listeria monocytogenes." Antimicrob Agents Chemother, 22, p. 289-94

Drug and food interactions

Moderate

fecal microbiota spores, live food

Applies to: fecal microbiota spores, live

ADJUST DOSING INTERVAL: There are no data regarding the effects of concurrent administration of oral fecal microbiota spores with food.

MANAGEMENT: The manufacturer of the oral formulation of fecal microbiota recommends that patients should have no food or drink except for a small amount of water for at least 8 hours prior to the first dose of fecal microbiota spores. The second and third doses of fecal microbiota spores should be taken on an empty stomach prior to the first meal of the day.

References (1)
  1. (2023) "Product Information. Vowst (fecal microbiota spores, live)." Aimmune Therapeutics
Minor

clarithromycin food

Applies to: amoxicillin / clarithromycin / vonoprazan

Grapefruit juice may delay the gastrointestinal absorption of clarithromycin but does not appear to affect the overall extent of absorption or inhibit the metabolism of clarithromycin. The mechanism of interaction is unknown but may be related to competition for intestinal CYP450 3A4 and/or absorptive sites. In an open-label, randomized, crossover study consisting of 12 healthy subjects, coadministration with grapefruit juice increased the time to reach peak plasma concentration (Tmax) of both clarithromycin and 14-hydroxyclarithromycin (the active metabolite) by 80% and 104%, respectively, compared to water. Other pharmacokinetic parameters were not significantly altered. This interaction is unlikely to be of clinical significance.

References (1)
  1. Cheng KL, Nafziger AN, Peloquin CA, Amsden GW (1998) "Effect of grapefruit juice on clarithromycin pharmacokinetics." Antimicrob Agents Chemother, 42, p. 927-9

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

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

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