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Drug Interactions between bismuth subcitrate potassium / metronidazole / tetracycline and Marax DF

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

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Interactions between your drugs

Moderate

tetracycline theophylline

Applies to: bismuth subcitrate potassium / metronidazole / tetracycline and Marax DF (ephedrine / hydroxyzine / theophylline)

Using tetracycline together with theophylline may increase the effects of theophylline. You should contact your doctor if you experience nausea, vomiting, diarrhea, headache, restlessness, insomnia, seizures, or an irregular heartbeat. You may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

metroNIDAZOLE hydrOXYzine

Applies to: bismuth subcitrate potassium / metronidazole / tetracycline and Marax DF (ephedrine / hydroxyzine / theophylline)

Using metroNIDAZOLE together with hydrOXYzine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

tetracycline bismuth subcitrate potassium

Applies to: bismuth subcitrate potassium / metronidazole / tetracycline and bismuth subcitrate potassium / metronidazole / tetracycline

Using bismuth subcitrate potassium together with tetracycline may decrease the effects of tetracycline. Administration of tetracycline and bismuth subcitrate potassium should be separated by two to three hours. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Minor

theophylline ePHEDrine

Applies to: Marax DF (ephedrine / hydroxyzine / theophylline) and Marax DF (ephedrine / hydroxyzine / theophylline)

Information for this minor interaction is available on the professional version.

Drug and food interactions

Major

metroNIDAZOLE food

Applies to: bismuth subcitrate potassium / metronidazole / tetracycline

Consumption of alcoholic beverages or products containing alcohol or propylene glycol during treatment with metroNIDAZOLE is not recommended. Doing so may occasionally trigger a reaction in some patients similar to the disulfiram reaction, which includes unpleasant effects such as flushing, throbbing in head and neck, throbbing headache, difficulty breathing, nausea, vomiting, sweating, thirst, chest pain, rapid heartbeat, palpitation, low blood pressure, dizziness, lightheadedness, blurred vision, and confusion. Rarely, more severe reactions may include abnormal heart rhythm, heart attack, heart failure, unconsciousness, convulsions, and even death. Patients treated with metroNIDAZOLE should continue to avoid using any products containing alcohol or propylene glycol for at least 3 days until after completion of therapy. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

tetracycline food

Applies to: bismuth subcitrate potassium / metronidazole / tetracycline

Do not take iron supplements, multivitamins, calcium supplements, antacids, or laxatives within 2 hours before or after taking tetracycline. These products can make tetracycline less effective in treating your infection. Do not take tetracycline with milk or other dairy products, unless your doctor has told you to. Dairy products can make it harder for your body to absorb the medication.

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Moderate

theophylline food

Applies to: Marax DF (ephedrine / hydroxyzine / theophylline)

Both smoking and excessive caffeine consumption can alter the blood levels of theophylline, which may affect the dosing. Tobacco and marijuana smoke (including secondhand exposure) generally reduces, while caffeine increases, blood levels. In addition, caffeine is a stimulant and may add to the side effects of theophylline such as headache, insomnia, and increases in blood pressure and heart rate. It is best to avoid smoking and to limit caffeine consumption during theophylline therapy. Talk to a healthcare professional if you have any questions or concerns. If you start smoking or undergo smoking cessation, your doctor may need to monitor your blood levels more closely to determine if you need a dose adjustment of theophylline. You should stop taking theophylline and seek medical attention if you experience potential signs and symptoms of excessive drug levels such as nausea, vomiting, persistent headache, insomnia, and rapid heartbeat. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

When theophylline is given with enteral (tube) feedings, blood levels may be decreased due to interference with its absorption. This may reduce the effectiveness of the medication. To minimize potential for interaction, you may interrupt the feeding for one hour before and one hour after the theophylline dose. You may need more frequent blood tests to monitor theophylline levels.

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Moderate

hydrOXYzine food

Applies to: Marax DF (ephedrine / hydroxyzine / theophylline)

Alcohol can increase the nervous system side effects of hydrOXYzine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with hydrOXYzine. Do not use more than the recommended dose of hydrOXYzine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

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Moderate

tetracycline food

Applies to: bismuth subcitrate potassium / metronidazole / tetracycline

Iron can bind to tetracycline in the gastrointestinal tract, which may prevent their absorption into the bloodstream and possibly reduce their effectiveness. To avoid or minimize the interaction, iron-containing medications and tetracycline should preferably be taken at least three to four hours apart in most cases. Talk to your doctor if you have any questions or concerns, or if you have trouble separating the dosing times. Your doctor may be able to prescribe alternatives that do not interact. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

theophylline food

Applies to: Marax DF (ephedrine / hydroxyzine / theophylline)

Ask your doctor before using theophylline together with caffeine. Using these medications together may increase some of the side effects of theophylline. This can cause nausea, vomiting, insomnia, tremors, restlessness, uneven heartbeats, and seizure (convulsions). Avoid drinks or foods that contain caffeine, such as coffee, tea, cola, and chocolate. You may need a dose adjustment or special test if you use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

ePHEDrine food

Applies to: Marax DF (ephedrine / hydroxyzine / theophylline)

Consumer information for this interaction is not currently available.

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.

MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.

References

  1. Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res 1 (1979): 45-52
  2. Cavanaugh JH, Griffith JD, Oates JA "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther 11 (1970): 656
  3. "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc PROD (2001):
  4. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals PROD (2001):
  5. "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals PROD (2001):
  6. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
  7. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
View all 7 references

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.