Skip to main content

Drug Interactions between Bumex and Mandol

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

Edit list (add/remove drugs)

Interactions between your drugs

Moderate

cefamandole bumetanide

Applies to: Mandol (cefamandole) and Bumex (bumetanide)

MONITOR: Limited data suggest that furosemide and possibly other loop diuretics may potentiate the nephrotoxicity of some cephalosporins. The exact mechanism of interaction is unknown, although furosemide has been shown to increase the plasma concentrations and/or reduce the clearance of several cephalosporins such as cephaloridine and ceftazidime. Data from an early study identified an association between diuretic use and acute renal failure during cephaloridine treatment. Specifically, 9 out of 36 patients who developed acute renal failure while on cephaloridine were also receiving a diuretic (primarily furosemide). Other risk factors included shock, infection, excessive dosage of cephaloridine, and concomitant use of other potentially nephrotoxic drugs. Several case reports have also suggested an increased risk of nephrotoxicity with the combination of furosemide and cephaloridine or cephalothin, and one study found that administration of furosemide or ethacrynic acid increased both the incidence and extent of proximal renal tubular necrosis in cephaloridine-treated mice and rats. In contrast, a study conducted in patients with preexisting moderate renal impairment found no effect of furosemide on the serum half-life of cefoxitin, and glomerular filtration rate was not affected during concomitant administration of cefoxitin and furosemide.

MANAGEMENT: Although data are primarily limited to cephaloridine, which is no longer commercially marketed, caution may be advisable in patients receiving a loop diuretic in combination with other cephalosporins. Renal function should be monitored, particularly when high dosages are used or when these medications are administered in the elderly or patients with preexisting renal impairment.

References

  1. Korn A, Eichler HG, Gasic S (1986) "A drug interaction study of ceftriaxone and frusemide in healthy volunteers." Int J Clin Pharmacol Ther Toxicol, 24, p. 262-4
  2. Lawson DH, Macadam RF, Singh H, et al. (1972) "Effect of furosemide on antibiotic-induced renal damage in rats." J Infect Dis, 126, p. 593-600
  3. Tilstone WJ, Semple PF, Lawson DH, Boyle JA (1977) "Effects of furosemide on glomerular filtration rate and clearance of practolol, digoxin, cephaloridine, and gentamicin." Clin Pharmacol Ther, 22, p. 389-94
  4. Trollfors B, Norrby R, Kristianson K, Nilsson NJ (1978) "Effects on renal function of treatment with cefoxitin alone or in combination with furosemide." Scand J Infect Dis, 13, p. 73-7
  5. Simpson IJ (1971) "Nephrotoxicity and acute renal failure associated with cephalothin and cephaloridine." N Z Med J, 74, p. 312-5
  6. Dodds MG, Foord RD (1970) "Enhancement by potent diuretics of renal tubular necrosis induced by cephaloridine." Br J Pharmacol, 40, p. 227-36
  7. Norrby R, Stenqvist K, Elgefors B (1976) "Interaction between cephaloridine and furosemide in man." Scand J Infect Dis, 8, p. 209-12
  8. Chrysos G, Gargalianos P, Lelekis M, Stefanou J, Kosmidis J (1995) "Pharmacokinetic interactions of ceftazidime and frusemide." J Chemother, 7 Suppl, p. 107-10
View all 8 references

Switch to consumer interaction data

Drug and food interactions

Moderate

cefamandole food

Applies to: Mandol (cefamandole)

GENERALLY AVOID: Some cephalosporins may occasionally induce a disulfiram-like reaction when coadministered with alcohol. The interaction has been reported for cefamandole, cefoperazone, cefotetan, and moxalactam. These agents contain an N-methylthiotetrazole (NMTT) side chain that may inhibit aldehyde dehydrogenase (ALDH) similar to disulfiram. Following ingestion of alcohol, inhibition of ALDH results in increased concentration of acetaldehyde, the accumulation of which produces an unpleasant physiologic response referred to as the 'disulfiram reaction'. Symptoms include flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, weakness, vertigo, blurred vision, and confusion. Severe reactions may result in respiratory depression, cardiovascular collapse, arrhythmias, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death. Cefonicid contains a structurally similar side chain but did not produce elevations in blood acetaldehyde or a disulfiram reaction to ethanol in 15 healthy volunteers given single and multiple one gram doses of the drug.

MANAGEMENT: Patients receiving cephalosporins with the NMTT side chain should avoid the concomitant use of alcohol and alcohol-containing products.

References

  1. Kline SS, Mauro VF, Forney RB Jr, et al. (1987) "Cefotetan-induced disulfiram-type reactions and hypoprothrombinemia." Antimicrob Agents Chemother, 31, p. 1328-31
  2. Freundt KJ, Kitson TM (1986) "Inactivation of aldehyde dehydrogenase by a putative metabolite of cefamandole." Infection, 14, p. 44-7
  3. Freundt KJ, Schreiner E, Christmann-Kleiss U (1985) "Cefamandole: a competitive inhibitor of aldehyde dehydrogenase." Infection, 13, p. 91
  4. McMahon FG (1980) "Disulfiram-like reaction to a cephalosporin." JAMA, 243, p. 2397
  5. Reeves DS, Davies AJ (1980) "Antabuse effect with cephalosporins." Lancet, 2, p. 540
  6. Brown KR, Guglielmo BJ, Pons VG, Jacobs RA (1982) "Theophylline elixir, moxalactam, and a disulfiram reaction." Ann Intern Med, 97, p. 621-2
  7. Umeda S, Arai T (1985) "Disulfiram-like reaction to moxalactam after celiac plexus alcohol block." Anesth Analg, 64, p. 377
  8. Foster TS, Raehl CL, Wilson HD (1980) "Disulfiram-like reaction associated with a parenteral cephalosporin." Am J Hosp Pharm, 37, p. 858-9
  9. McMahon FG, Ryan JR, Jain AK, LaCorte W, Ginzler F (1987) "Absence of disulfiram-type reactions to single and multiple doses of cefonicid: a placebo-controlled study." J Antimicrob Chemother, 20, p. 913-8
View all 9 references

Switch to consumer interaction data

Moderate

bumetanide food

Applies to: Bumex (bumetanide)

MONITOR: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.

MANAGEMENT: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.

References

  1. Sternbach H (1991) "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol, 11, p. 390-1
  2. Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA (1984) "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med, 101, p. 498-9
  3. Feder R (1991) "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry, 52, p. 139
  4. Ellison JM, Milofsky JE, Ely E (1990) "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry, 51, p. 385-6
  5. Rodriguez de la Torre B, Dreher J, Malevany I, et al. (2001) "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit, 23, p. 435-40
  6. Cerner Multum, Inc. "Australian Product Information."
  7. Pacher P, Kecskemeti V (2004) "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des, 10, p. 2463-75
  8. Andrews C, Pinner G (1998) "Postural hypotension induced by paroxetine." BMJ, 316, p. 595
View all 8 references

Switch to consumer interaction data

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

Report options

Loading...
QR code containing a link to this page

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.

Medical Disclaimer