Drug Interactions between Corphedra and dexamethasone / moxifloxacin

MONITOR CLOSELY: Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism is unknown. Tendinitis and tendon rupture have most frequently involved the Achilles tendon, although cases involving the rotator cuff (the shoulder), the hand, the biceps, and the thumb have also been reported. Some have required surgical repair or resulted in prolonged disability. Tendon rupture can occur during or up to several months after completion of fluoroquinolone therapy.

MANAGEMENT: Caution is recommended if fluoroquinolones are prescribed in combination with corticosteroids, particularly in patients with other concomitant risk factors (e.g., age over 60 years; recipient of kidney, heart, and/or lung transplant). Patients should be advised to stop taking the fluoroquinolone, avoid exercise and use of the affected area, and promptly contact their physician if they experience pain, swelling, or inflammation of a tendon. In general, fluoroquinolones should only be used to treat conditions that are proven or strongly suspected to be caused by bacteria and only if the benefits outweigh the risks.

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In one study, after treatment with ephedrine, a 36% decrease in mean dexamethasone half-life and a 42% increase in the clearance of plasma dexamethasone has been reported. The mechanism of this interaction has not been reported. The authors of the study recommend caution when prescribing ephedrine for asthmatics requiring long term therapy with dexamethasone. The authors of the study further suggest that since ephedrine accelerates labeled dexamethasone clearance while theophylline did not, theophylline may be a more appropriate bronchodilator to use in this patient population.

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