Drug Interactions between cholera vaccine, live and tinidazole
This report displays the potential drug interactions for the following 2 drugs:
- cholera vaccine, live
- tinidazole
Interactions between your drugs
tinidazole cholera vaccine, live
Applies to: tinidazole and cholera vaccine, live
ADJUST DOSING INTERVAL: The use of live, attenuated cholera vaccine with systemic antibiotics may result in a diminished immunologic response to the vaccine. Some antibiotics may be active against the vaccine strain of Vibrio cholerae, thereby preventing a sufficient degree of multiplication to occur in order to induce a protective immune response.
MANAGEMENT: Live, attenuated cholera vaccine should not be administered during or for at least 14 days after treatment with systemic antibiotics.
References
- "Product Information. Vaxchora (cholera vaccine, live)." PaxVax (2016):
Drug and food interactions
tinidazole food
Applies to: tinidazole
GENERALLY AVOID: Use of alcohol or products containing alcohol during nitroimidazole therapy may result in a disulfiram-like reaction in some patients. There have been a few case reports involving metronidazole, although data overall are not convincing. The presumed mechanism is inhibition of aldehyde dehydrogenase (ALDH) by metronidazole in a manner similar to disulfiram. Following ingestion of alcohol, inhibition of ALDH results in increased concentrations of acetaldehyde, the accumulation of which can produce 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, arrhythmia, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death. However, some investigators have questioned the disulfiram-like properties of metronidazole. One study found neither elevations in blood acetaldehyde nor objective or subjective signs of a disulfiram-like reaction to ethanol in six subjects treated with metronidazole (200 mg three times a day for 5 days) compared to six subjects who received placebo.
MANAGEMENT: Because clear evidence is lacking concerning the safety of ethanol use during nitroimidazole therapy, patients should be apprised of the potential for interaction and instructed to avoid alcoholic beverages and products containing alcohol or propylene glycol while using oral, intravenous, or vaginal preparations of a nitroimidazole. Alcoholic beverages should not be consumed for up to 3 days after completion of systemic nitroimidazole therapy.
References
- Giannini AJ, DeFrance DT "Metronidazole and alcohol: potential for combinative abuse." J Toxicol Clin Toxicol 20 (1983): 509-15
- Alexander I "Alcohol-antabuse syndrome in patients receiving metronidazole during gynaecological treatment." Br J Clin Pract 39 (1985): 292-3
- Harries DP, Teale KF, Sunderland G "Metronidazole and alcohol: potential problems." Scott Med J 35 (1990): 179-80
- Edwards DL, Fink PC, Van Dyke PO "Disulfiram-like reaction associated with intravenous trimethoprim-sulfamethoxazole and metronidazole." Clin Pharm 5 (1986): 999-1000
- "Product Information. Flagyl (metronidazole)." Searle PROD (2002):
- Williams CS, Woodcock KR "Do ethanol and metronidazole interact to produce a disulfiram-like reaction?." Ann Pharmacother 34 (2000): 255-7
- Visapaa JP, Tillonen JS, Kaihovaara PS, Salaspuro MP "Lack of disulfiram-like reaction with metronidazole and ethanol." Ann Pharmacother 36 (2002): 971-4
- Krulewitch CJ "An unexpected adverse drug effect." J Midwifery Womens Health 48 (2003): 67-8
- "Product Information. Tindamax (tinidazole)." Presutti Laboratories Inc (2004):
cholera vaccine, live food
Applies to: cholera vaccine, live
ADJUST DOSING INTERVAL: There are no data regarding the concurrent administration of cholera oral vaccine with food or beverages.
MANAGEMENT: The manufacturer recommends that patients avoid eating or drinking for 60 minutes before and after administration of cholera oral vaccine.
References
- "Product Information. Vaxchora (cholera vaccine, live)." PaxVax (2016):
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
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
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