Drug Interactions between ceftibuten and cholera vaccine, live

ADJUST DOSING INTERVAL: Food reduces the oral absorption and bioavailability of ceftibuten. According to the product labeling, administration of ceftibuten oral suspension with a high-fat breakfast decreased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 26% and 17%, respectively. Administration of ceftibuten capsules with a standardized breakfast decreased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 18% and 8%, respectively.

MANAGEMENT: To ensure maximal oral absorption, ceftibuten oral suspension should be taken at least two hours before or one hour after a meal.

ADJUST DOSING INTERVAL: Coadministration of oral cholera vaccine with food or an oral beverage may impair its efficacy. The formulations of both the inactivated and live, attenuated oral cholera vaccines (Dukoral and Vaxchora, respectively) are acid-labile, and must be administered with a buffer. According to the manufacturer, eating and drinking may interfere with the protective effect of the buffer. However, clinical data are not available.

MANAGEMENT: It is recommended that patients avoid eating or drinking for 60 minutes before and after administration of either Dukoral or Vaxchora oral cholera vaccines.