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Drug Interactions between atovaquone and Prepopik

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

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Interactions between your drugs

Moderate

atovaquone sodium picosulfate

Applies to: atovaquone and Prepopik (citric acid/magnesium oxide/sodium picosulfate)

GENERALLY AVOID: Theoretically, use of sodium picosulfate during or following antibiotic treatment may result in a reduced laxative effect of sodium picosulfate. The proposed mechanism involves antibiotic-induced reduction of colonic bacteria that hydrolyze sodium picosulfate, a prodrug, to its active metabolite bis-(p-hydroxyphenyl)-pyridyl-2-methane (BHPM), a compound that stimulates colonic peristalsis. The clinical significance of this effect remains unknown.

MANAGEMENT: Consider use of an alternate laxative in patients who have recently taken or are currently taking an antibiotic. If concomitant use is required, additional bowel cleansing and colonoscopy may be required.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. (2022) "Product Information. Prepopik (citric acid/Mg oxide/Na picosulfate)." Ferring Pharmaceuticals Inc
  3. Cerner Multum, Inc. (2015) "Canadian Product Information."
  4. (2022) "Product Information. Clenpiq (citric acid/Mg oxide/Na picosulfate)." Ferring Pharmaceuticals Inc
  5. (2018) MHRA. Medicines & Healthcare products Regulatory Agency (general site Reference) http://www.mhra.gov.uk/spc-pil/index.htm
View all 5 references

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Drug and food interactions

Moderate

atovaquone food

Applies to: atovaquone

ADJUST DOSING INTERVAL: Food, particularly high-fat food, significantly enhances the oral absorption and bioavailability of atovaquone. In 16 healthy volunteers, administration of a single 750 mg dose of atovaquone suspension following a standard breakfast (23 g fat: 610 kCal) resulted in an approximately 3.4-fold increase in the mean peak plasma concentration (Cmax) and a 2.5-fold increase in the mean area under the plasma concentration-time curve (AUC) of atovaquone compared to administration following an overnight fast. In a study consisting of 19 HIV-infected volunteers receiving atovaquone suspension 500 mg/day, Cmax and AUC of atovaquone increased by 72% and 66%, respectively, in the fed state relative to the fasting state.

MANAGEMENT: To ensure maximal oral absorption, atovaquone products (suspension, tablet, or in combination with proguanil) should be administered with a meal or milky drink, or enteral nutrition at the same time(s) each day. Because plasma atovaquone concentrations have been shown to correlate with the likelihood of successful treatment and in some cases, survival, alternative therapies may be appropriate for patients who have difficulty taking atovaquone with food.

References

  1. (2001) "Product Information. Mepron (atovaquone)." Glaxo Wellcome
  2. (2001) "Product Information. Malarone (atovaquone-proguanil)." Glaxo Wellcome
  3. Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT (2009) "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm, 66, p. 1438-67

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Moderate

sodium picosulfate food

Applies to: Prepopik (citric acid/magnesium oxide/sodium picosulfate)

ADJUST DOSING INTERVAL: Bowel cleansing products can increase the gastrointestinal transit rate. Oral medications administered within one hour of the start of administration of the bowel cleansing solution may be flushed from the gastrointestinal tract and not properly absorbed.

MANAGEMENT: Patients should be advised that absorption of oral medications may be impaired during bowel cleansing treatment. Oral medications (e.g., anticonvulsants, oral contraceptives, antidiabetic agents, antibiotics) should not be administered during and within one hour of starting bowel cleansing treatment whenever possible. However, if concomitant use cannot be avoided, monitoring for reduced therapeutic effects may be advisable.

References

  1. "Product Information. Golytely (polyethylene glycol 3350 with electrolytes)." Braintree
  2. (2022) "Product Information. Prepopik (citric acid/Mg oxide/Na picosulfate)." Ferring Pharmaceuticals Inc

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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

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

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