Drug Interactions between Diamox and Urobiotic-250
This report displays the potential drug interactions for the following 2 drugs:
- Diamox (acetazolamide)
- Urobiotic-250 (oxytetracycline/phenazopyridine/sulfamethizole)
Interactions between your drugs
acetaZOLAMIDE oxytetracycline
Applies to: Diamox (acetazolamide) and Urobiotic-250 (oxytetracycline / phenazopyridine / sulfamethizole)
MONITOR: The coadministration of diuretics with tetracyclines may result in decreased renal function and abnormalities in electrolytes and acid-base balance. As a class, tetracyclines can cause anti-anabolic effects which have led to increased blood urea nitrogen (BUN), azotemia, acidosis, and hyperphosphatemia. Diuretics have the potential to cause electrolyte and metabolic abnormalities, as well as worsen renal function. When used together, it is possible that these two classes of medications could have additive adverse effects.
MANAGEMENT: Patients on concomitant therapy with tetracycline antibiotics and diuretics should have their renal function and electrolytes monitored closely. The risk of additive adverse effects on the patient's renal function, electrolytes, and acid-base balance differs depending on the type of diuretic being used, the specific tetracycline antibiotic, and the clinical status of the patient. The manufacturer's labeling should be consulted for more specific recommendations.
References
- Jick H, Slone D, Shapiro S, et al. (1972) "Tetracycline and drug-attributed rises in blood urea nitrogen: a report from the Boston Collaborative Drug Surveillance Program." JAMA, 220, p. 377-9
- Garty M, Hurwitz A (1980) "Effect of cimetidine and antacids on gastrointestinal absorption of tetracycline." Clin Pharmacol Ther, 28, p. 203-7
- Tannenberg AM (1972) "Tetracycline and rises in urea nitrogen." JAMA, 221, p. 713
- Alexander MR (1972) "Tetracycline and rises in urea nitrogen." JAMA, 221, p. 713-4
- (2022) "Product Information. Xerava (eravacycline)." PAION Deutschland GmbH
- (2021) "Product Information. Xerava (eravacycline)." Tetraphase Pharmaceuticals, Inc
- (2022) "Product Information. Ospolot (sulthiame)." Phebra Pty Ltd, 10
- (2022) "Product Information. AcetaZOLAMIDE (acetaZOLAMIDE)." Mylan Institutional (formerly UDL Laboratories)
- (2021) "Product Information. AMILoride Hydrochloride (aMILoride)." Padagis
- (2020) "Product Information. Spironolactone (spironolactone)." Amneal Pharmaceuticals
- (2022) "Product Information. Kerendia (finerenone)." Bayer Pharmaceutical Inc
- (2021) "Product Information. Eplerenone (eplerenone)." Westminster Pharmaceuticals LLC
Drug and food interactions
oxytetracycline food
Applies to: Urobiotic-250 (oxytetracycline / phenazopyridine / sulfamethizole)
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
- (2001) "Product Information. Achromycin (tetracycline)." Lederle Laboratories
- (2001) "Product Information. Declomycin (demeclocycline)." Lederle Laboratories
oxytetracycline food
Applies to: Urobiotic-250 (oxytetracycline / phenazopyridine / sulfamethizole)
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
- Neuvonen PJ (1976) "Interactions with the absorption of tetracyclines." Drugs, 11, p. 45-54
- Gothoni G, Neuvonen PJ, Mattila M, Hackman R (1972) "Iron-tetracycline interaction: effect of time interval between the drugs." Acta Med Scand, 191, p. 409-11
- Venho VM, Salonen RO, Mattila MJ (1978) "Modification of the pharmacokinetics of doxycycline in man by ferrous sulphate or charcoal." Eur J Clin Pharmacol, 14, p. 277-80
- (2002) "Product Information. Minocin (minocycline)." Lederle Laboratories
- Campbell NR, Hasinoff BB (1991) "Iron supplements: a common cause of drug interactions." Br J Clin Pharmacol, 31, p. 251-5
- Bateman FJ (1970) "Effects of tetracyclines." Br Med J, 4, p. 802
- Neuvonen PJ, Gothoni G, Hackman R, Bjorksten K (1970) "Interference of iron with the absorption of tetracyclines in man." Br Med J, 4, p. 532-4
- Greenberger NJ (1971) "Absorption of tetracyclines: interference by iron." Ann Intern Med, 74, p. 792-3
- Neuvonen PJ, Penttila O (1974) "Effect of oral ferrous sulphate on the half-life of doxycycline in man." Eur J Clin Pharmacol, 7, p. 361-3
- (2018) "Product Information. Seysara (sarecycline)." Allergan Inc
- (2018) "Product Information. Nuzyra (omadacycline)." Paratek Pharmaceuticals, Inc.
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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