Drug Interactions between Biocef and Fosteum

ADJUST DOSING INTERVAL: Oral products containing zinc such as mineral supplements and multivitamins may interfere with the gastrointestinal absorption of cephalexin, ceftibuten or cephradine. In one pharmacokinetic study (n=12), concurrent administration of zinc sulfate (250 mg, single oral dose) and cephalexin (500 mg, single oral dose) decreased cephalexin maximum concentration (Cmax) and systemic exposure (AUC; 0-inf) by 31.05% and 27.4%, respectively. However, in the same study, when zinc sulfate was administered 3 hours after the cephalexin dose, no significant alteration in cephalexin pharmacokinetics were observed.

MANAGEMENT: Oral medications or mineral supplements that contain zinc are recommended to be administered at least 3 hours after the cephalexin, ceftibuten or cephradine dose.

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Antibiotics may decrease the effects of soy isoflavones such as genistein and daidzein. Soy isoflavones are converted into their active forms in part by intestinal bacteria, thus alteration of the intestinal microflora by antibiotics may decrease availability of activated isoflavones. Data are limited. In a study consisting of 11 children ages 4 to 17 years who were fed a body weight-adjusted dose of soy nuts, the urinary excretion rates for genistein and all native isoflavones combined (i.e., genistein, daidzein, and glycitein) were reduced by 37% and 24%, respectively, during oral antibiotic treatment for infection compared to the healthy state when not on antibiotics. The urinary excretion rate for total isoflavones (i.e., native and activated isoflavones combined) was also reduced by 24% during antibiotic administration. The clinical significance of these changes is unknown. There was some indication that the infectious process itself may have played a role, either by altering the colonic flora or some other mechanism, although the extent is unclear.

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