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Interactions between Ceftobiprole medocaril and Ezetimibe

1 drug interaction and 7 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

ezetimibe ceftobiprole

Applies to: ezetimibe and ceftobiprole medocaril
Generally avoid

Coadministration with ceftobiprole may increase the plasma concentrations and the risk of adverse effects of drugs that are substrates of organic anion transporting polypeptide (OATP) 1B1 and/or OATP1B3. The proposed mechanism is decreased clearance due to ceftobiprole-mediated inhibition of OATP1B1 and/or OATP1B3.

Management

Concomitant use of ceftobiprole with drugs that are substrates of OATP1B1 and/or OATP1B3 is not recommended. Clinical and laboratory monitoring may be appropriate whenever ceftobiprole is added to or withdrawn from therapy with these drugs. Dosage adjustments may be considered if an interaction is suspected. Patients should be monitored for the development of adverse effects.

References (12)
  1. (2001) "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb
  2. (2001) "Product Information. Zocor (simvastatin)." Merck & Co., Inc
  3. (2001) "Product Information. Lipitor (atorvastatin)." Parke-Davis
  4. (2003) "Product Information. Crestor (rosuvastatin)." AstraZeneca Pharma Inc
  5. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  6. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
  7. Neuvonen PJ, Niemi M, Backman JT (2006) "Drug interactions with lipid-lowering drugs: Mechanisms and clinical relevance." Clin Pharmacol Ther, 80, p. 565-81
  8. Cerner Multum, Inc. "Australian Product Information."
  9. 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
  10. Cerner Multum, Inc. (2015) "Canadian Product Information."
  11. Morival C, Westerlynck R, Bouzille G, Cuggia M, Le Corre P (2018) "Prevalence and nature of statin drug-drug interactions in a university hospital by electronic health record mining." Eur J Clin Pharmacol, 74, p. 525-534
  12. Hua WJ, Hua WX, Fang HJ (2012) "Role of OATP1B1 in pharmacokinetics and DDI of novel statins." Cardiovasc Ther, 30, e234-41

Food/lifestyle interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Disease interactions

7 potential interactions Applies to: 6 conditions, including Seizures, Diabetes Mellitus, Hemodialysis, Liver Disease, and Noninfectious Colitis.

Diabetes Mellitus

Moderate:

ceftobiprole medocaril

The ceftobiprole in ceftobiprole medocaril has a moderate potential interaction with Diabetes Mellitus.

Use of cephalosporins may result in a false-positive reaction for glucose in urine with certain methods (e.g., Clinitest tablets). Glucose tests based on enzymatic glucose oxidase reactions are recommended for patients receiving cephalosporins.

Hemodialysis

Moderate:

ceftobiprole medocaril

The ceftobiprole in ceftobiprole medocaril has a moderate potential interaction with Hemodialysis.

Most cephalosporin antibiotics are removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis. Cefonicid, cefixime, and ceftriaxone are not significantly removed by hemodialysis.

Liver Disease

Major:

ezetimibe

Ezetimibe has a major potential interaction with Liver Disease.

Ezetimibe is not recommended for use in patients with moderate to severe hepatic impairment (Child-Pugh B or C) due to the unknown effects of increased exposure in this population.

Moderate:

ceftobiprole medocaril

The ceftobiprole in ceftobiprole medocaril has a moderate potential interaction with Liver Disease.

The effect of hepatic dysfunction on ceftobiprole pharmacokinetics is unknown.

Noninfectious Colitis

Major:

ceftobiprole medocaril

The ceftobiprole in ceftobiprole medocaril has a major potential interaction with Noninfectious Colitis.

Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.

Renal Dysfunction

Moderate:

ceftobiprole medocaril

The ceftobiprole in ceftobiprole medocaril has a moderate potential interaction with Renal Dysfunction.

The ceftobiprole dosage is reduced in adult patients with renal dysfunction (CrCl less than 50 mL/min, including CrCl less than 15 mL/min with or without hemodialysis); the dosage is also reduced in pediatric patients (aged 2 to less than 18 years) with renal dysfunction (estimated GFR 15 to less than 50 mL/min/1.73 m2). Renal dysfunction increases the AUC of ceftobiprole in adult patients (and is predicted to increase ceftobiprole AUC in pediatric patients), which may increase the risk of drug-related adverse reactions. The effect of any degree of renal dysfunction in pediatric patients younger than 2 years or in those aged 2 to less than 18 years with an estimated GFR less than 15 mL/min/1.73 m2 (receiving or not receiving hemodialysis) on ceftobiprole pharmacokinetics is unknown.

Seizures

Moderate:

ceftobiprole medocaril

The ceftobiprole in ceftobiprole medocaril has a moderate potential interaction with Seizures.

Cephalosporins have been implicated in triggering seizures. Nonconvulsive status epilepticus, encephalopathy, coma, asterixis, neuromuscular excitability, and myoclonia have been reported with cephalosporins, particularly in patients with a history of epilepsy and/or when recommended dosages of cephalosporins were exceeded due to renal dysfunction. Dosage should be adjusted based on the degree of renal function. Anticonvulsant therapy should be continued in patients with known seizure disorders. If CNS adverse reactions including seizures occur, patients should undergo a neurological evaluation to determine whether treatment should be discontinued.

More resources

ceftobiprole medocaril

A total of 76 drugs are known to interact with ceftobiprole medocaril.

ezetimibe

A total of 72 drugs are known to interact with ezetimibe.

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.