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Drug Interactions between Charcoal Plus DS and Tetracon

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

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Interactions between your drugs

Moderate

tetracycline charcoal

Applies to: Tetracon (tetracycline) and Charcoal Plus DS (charcoal)

GENERALLY AVOID: Charcoal may reduce the absorption of many drugs and can absorb enterohepatically circulated drugs. Clinical utility may be the reduction either of the effects or of the toxicity of many drugs. Activated charcoal may adsorb any therapeutic agents administered while it is in the gastrointestinal tract.

MANAGEMENT: The regular ingestion of charcoal should be avoided by patients requiring maintenance medications. If concomitant use is necessary, the dosage or route of administration may need to be altered.

References

  1. Decker WJ, Shpall RA, Corby DG "Inhibition of aspirin absorption by activated charcoal and apomorphine." Clin Pharmacol Ther 10 (1969): 710-3
  2. Knadler MP, Bergstrom RF, Callaghan JT, Obermeyer BD, Rubin A "Absorption studies of the H2-blocker nizatidine." Clin Pharmacol Ther 42 (1987): 514-20
  3. Wing LM, Miners JO, Birkett DJ, et al. "Lidocaine disposition: sex differences and effects of cimetidine." Clin Pharmacol Ther 35 (1984): 695-701
  4. Scheufler E, Bos I "Influence of peroral charcoal on pharmacokinetics and intestinal toxicity of intravenously given methotrexate." Arch Int Pharmacodyn Ther 261 (1983): 180-5
  5. Gadgil SD, Damle SR, Advani SH, Vaidya AB "Effect of activated charcoal on the pharmacokinetics of high-dose methotrexate." Cancer Treat Rep 66 (1982): 1169-71
  6. Park GD, Spector R, Goldberg MJ, Johnson GF "Expanded role of charcoal therapy in the poisoned and overdosed patient." Arch Intern Med 146 (1986): 969-73
  7. Watson WA "Factors influencing the clinical efficacy of activated charcoal." Drug Intell Clin Pharm 21 (1987): 160-6
  8. Kivisto KT, Neuvonen PJ "The effect of cholestyramine and activated charcoal on glipizide absorption." Br J Clin Pharmacol 30 (1990): 733-6
  9. Dolgin JG, Nix DE, Sanchez J, Watson WA "Pharmacokinetic simulation of the effect of multiple-dose activated charcoal in phenytoin poisoning: report of two pediatric cases." DICP 25 (1991): 646-9
  10. Rowden AM, Spoor JE, Bertino JS, Jr "The effect of activated charcoal on phenytoin pharmacokinetics." Ann Emerg Med 19 (1990): 1144-7
  11. Farrar HC, Herold DA, Reed MD "Acute valproic acid intoxication: enhanced drug clearance with oral-activated charcoal." Crit Care Med 21 (1993): 299-301
  12. Howard CE, Roberts RS, Ely DS, Moye RA "Use of multiple-dose activated charcoal in phenytoin toxicity." Ann Pharmacother 28 (1994): 201-3
  13. Chernish SM, Wolen RL, Rodda BE "Adsorption of propoxyphene hydrochloride by activated charcoal." Clin Toxicol 5 (1972): 317-29
  14. Glab WN, Corby DG, Decker WJ, Coldiron VR "Decreased absorption of propoxyphene by activated charcoal." J Toxicol Clin Toxicol 19 (1982): 129-38
  15. Karkkainen S, Neuvonen PJ "Effect of oral charcoal and urine pH on dextropropoxyphene pharmacokinetics." Int J Clin Pharmacol Ther Toxicol 23 (1985): 219-25
  16. Wakabayashi Y, Maruyama S, Hachimura K, Ohwada T "Activated charcoal interrupts enteroenteric circulation of phenobarbital." J Toxicol Clin Toxicol 32 (1994): 419-24
  17. Reed MD "Oral activated charcoal therapy." Am J Emerg Med 6 (1988): 318
  18. Neuvonen PJ "Clinical pharmacokinetics of oral activated charcoal in acute intoxications." Clin Pharmacokinet 7 (1982): 465-89
  19. Naveau S, Bonhomme L, Preaux N, Chaput JC "A pure charcoal suspension for colonoscopic tattoo." Gastrointest Endosc 37 (1991): 624-5
  20. Ilkhanipour K, Yealy DM, Krenzelok EP "Activated charcoal surface area and its role in multiple-dose charcoal therapy." Am J Emerg Med 11 (1993): 583-5
  21. Saetta JP "Gastric decontaminating procedures: is it time to call a stop?" J R Soc Med 86 (1993): 396-9
  22. Orisakwe OE "Activated charcoal: is failure to use it negligence or ignorance?" South Med J 87 (1994): 165-8
  23. Herrington AM, Clifton GD "Toxicology and management of acute drug ingestions in adults." Pharmacotherapy 15 (1995): 182-200
  24. Bonuccelli U, Piccini P, Del Dotto P, Pavese N, D'Antonio P, Muratorio A "Apomorphine test in de novo Parkinson's disease." Funct Neurol 7 (1992): 295-8
  25. "Product Information. Trileptal (oxcarbazepine)." Novartis Pharmaceuticals PROD (2001):
View all 25 references

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Drug and food interactions

Moderate

tetracycline food

Applies to: Tetracon (tetracycline)

ADJUST DOSING INTERVAL: Administration with food, particularly dairy products, significantly reduces tetracycline absorption. The calcium content of these foods forms nonabsorbable chelates with tetracycline.

MANAGEMENT: Tetracycline should be administered one hour before or two hours after meals.

References

  1. "Product Information. Achromycin (tetracycline)." Lederle Laboratories PROD (2001):
  2. "Product Information. Declomycin (demeclocycline)." Lederle Laboratories PROD (2001):

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Moderate

tetracycline food

Applies to: Tetracon (tetracycline)

GENERALLY AVOID: The bioavailability of oral tetracyclines and iron salts may be significantly decreased during concurrent administration. Therapeutic failure may result. The proposed mechanism is chelation of tetracyclines by the iron cation, forming an insoluble complex that is poorly absorbed from the gastrointestinal tract. In ten healthy volunteers, simultaneous oral administration of ferrous sulfate 200 mg and single doses of various tetracyclines (200 mg to 500 mg) resulted in reductions in the serum levels of methacycline and doxycycline by 80% to 90%, oxytetracycline by 50% to 60%, and tetracycline by 40% to 50%. In another study, 300 mg of ferrous sulfate reduced the absorption of tetracycline by 81% and that of minocycline by 77%. Conversely, the absorption of iron has been shown to be decreased by up to 78% in healthy subjects and up to 65% in patients with iron depletion when ferrous sulfate 250 mg was administered with tetracycline 500 mg. Available data suggest that administration of iron 3 hours before or 2 hours after a tetracycline largely prevents the interaction with most tetracyclines except doxycycline. Due to extensive enterohepatic cycling, iron binding may occur with doxycycline even when it is given parenterally. It has also been shown that when iron is administered up to 11 hours after doxycycline, serum concentrations of doxycycline may still be reduced by 20% to 45%.

MANAGEMENT: Coadministration of a tetracycline with any iron-containing product should be avoided if possible. Otherwise, patients should be advised to stagger the times of administration by at least three to four hours, although separating the doses may not prevent the interaction with doxycycline.

References

  1. Neuvonen PJ "Interactions with the absorption of tetracyclines." Drugs 11 (1976): 45-54
  2. Gothoni G, Neuvonen PJ, Mattila M, Hackman R "Iron-tetracycline interaction: effect of time interval between the drugs." Acta Med Scand 191 (1972): 409-11
  3. Venho VM, Salonen RO, Mattila MJ "Modification of the pharmacokinetics of doxycycline in man by ferrous sulphate or charcoal." Eur J Clin Pharmacol 14 (1978): 277-80
  4. "Product Information. Minocin (minocycline)." Lederle Laboratories PROD (2002):
  5. Campbell NR, Hasinoff BB "Iron supplements: a common cause of drug interactions." Br J Clin Pharmacol 31 (1991): 251-5
  6. Bateman FJ "Effects of tetracyclines." Br Med J 4 (1970): 802
  7. Neuvonen PJ, Gothoni G, Hackman R, Bjorksten K "Interference of iron with the absorption of tetracyclines in man." Br Med J 4 (1970): 532-4
  8. Greenberger NJ "Absorption of tetracyclines: interference by iron." Ann Intern Med 74 (1971): 792-3
  9. Neuvonen PJ, Penttila O "Effect of oral ferrous sulphate on the half-life of doxycycline in man." Eur J Clin Pharmacol 7 (1974): 361-3
  10. "Product Information. Seysara (sarecycline)." Allergan Inc (2018):
  11. "Product Information. Nuzyra (omadacycline)." Paratek Pharmaceuticals, Inc. (2018):
View all 11 references

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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

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