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Drug Interactions between Bonisara and levofloxacin

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

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Interactions between your drugs

Moderate

levoFLOXacin strontium gluconate

Applies to: levofloxacin and Bonisara (cyanocobalamin / folic acid / pyridoxine / strontium gluconate)

GENERALLY AVOID: Divalent cations such as strontium may interfere with the absorption of orally administered quinolone and tetracycline antibiotics. The mechanism is strontium chelation of the antibiotic in the gastrointestinal tract, resulting in a nonabsorbable complex.

MANAGEMENT: As a precautionary measure, strontium treatment should be interrupted during quinolone or tetracycline therapy.

References (3)
  1. (2007) "Product Information. Bonisara (cyanocobalamin/folic acid/pyridoxine/strontiu)." Zylera Pharamaceuticals
  2. (2018) "Product Information. Seysara (sarecycline)." Allergan Inc
  3. (2018) "Product Information. Nuzyra (omadacycline)." Paratek Pharmaceuticals, Inc.

Drug and food interactions

Moderate

folic acid food

Applies to: Bonisara (cyanocobalamin / folic acid / pyridoxine / strontium gluconate)

MONITOR: Ethanol may increase folic acid elimination and folic acid absorption is decreased in chronic alcoholics. Excessive alcohol consumption may lead to folate deficiency.

MANAGEMENT: Monitoring of patient response to folic acid supplementation if they also consume alcohol regularly may be recommended.

References (5)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."
  3. Agencia Española de Medicamentos y Productos Sanitarios Healthcare (2008) Centro de información online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html
  4. Cerner Multum, Inc (2015) "ANVISA Bulário Eletrônico."
  5. (2017) "Product Information. Folic Acid (folic acid)." Method Pharmaceuticals, LLC
Moderate

levoFLOXacin food

Applies to: levofloxacin

ADJUST DOSING INTERVAL: Food may reduce the oral absorption and bioavailability of levofloxacin. According to the drug product labeling, administration of levofloxacin 500 mg with food prolonged the time to peak concentration by 1 hour and decreased the Cmax decreased by 25% following administration of the oral solution and by 14% following administration of the oral tablet.

MANAGEMENT: To ensure maximal and consistent oral absorption, levofloxacin oral solution should be taken at least one hour before or two hours after meals. For administration of the oral solution with continuous enteral nutrition, some experts recommend that the tube feeding should be interrupted for one hour before and two hours after the dose of levofloxacin. The oral tablets may be taken without regard to food.

References (1)
  1. 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
Moderate

strontium gluconate food

Applies to: Bonisara (cyanocobalamin / folic acid / pyridoxine / strontium gluconate)

ADJUST DOSING INTERVAL: Concomitant administration of strontium with food or milk products may decrease its bioavailability by 60% to 70%.

MANAGEMENT: Strontium salts should be taken at least two hours before or two hours after food or milk products, and preferably at bedtime.

References (1)
  1. (2007) "Product Information. Bonisara (cyanocobalamin/folic acid/pyridoxine/strontiu)." Zylera Pharamaceuticals

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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