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Drug Interactions between diphenhydramine / magnesium salicylate and omadacycline

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

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Interactions between your drugs

Moderate

magnesium salicylate omadacycline

Applies to: diphenhydramine / magnesium salicylate and omadacycline

ADJUST DOSING INTERVAL: Administration of a tetracycline with aluminum, calcium, or magnesium salts significantly decreases tetracycline serum concentrations. The proposed mechanism is chelation of tetracycline by the cation, forming an insoluble complex that is poorly absorbed from the gastrointestinal tract. The interaction has also been reported with parenteral doxycycline and oral antacids.

MANAGEMENT: The administration of tetracyclines and preparations containing aluminum, magnesium, or calcium should be separated by two to four hours. When coadministered with Suprep Bowel Prep (magnesium/potassium/sodium sulfates), the manufacturer recommends administering tetracycline antibiotics at least 2 hours before and not less than 6 hours after Suprep Bowel Prep to avoid chelation with magnesium.

References

  1. Neuvonen PJ "Interactions with the absorption of tetracyclines." Drugs 11 (1976): 45-54
  2. Deppermann KM, Lode H, Hoffken G, Tschink G, Kalz C, Koeppe P "Influence of ranitidine, pirenzepine, and aluminum magnesium hydroxide on the bioavailability of various antibiotics, including amoxicillin, cephalexin, doxycycline, and amoxicillin-clavulanic acid." Antimicrob Agents Chemother 33 (1989): 1901-7
  3. Nguyen VX, Nix DE, Gillikin S, Schentag JJ "Effect of oral antacid administration on the pharmacokinetics of intravenous doxycycline." Antimicrob Agents Chemother 33 (1989): 434-6
  4. Garty M, Hurwitz A "Effect of cimetidine and antacids on gastrointestinal absorption of tetracycline." Clin Pharmacol Ther 28 (1980): 203-7
  5. Gotz VP, Ryerson GG "Evaluation of tetracycline on theophylline disposition in patients with chronic obstructive airways disease." Drug Intell Clin Pharm 20 (1986): 694-6
  6. McCormack JP, Reid SE, Lawson LM "Theophylline toxicity induced by tetracycline." Clin Pharm 9 (1990): 546-9
  7. D'Arcy PF, McElnay JC "Drug-antacid interactions: assessment of clinical importance." Drug Intell Clin Pharm 21 (1987): 607-17
  8. Upton RA "Pharmacokinetic interactions between theophylline and other medication (Part I)." Clin Pharmacokinet 20 (1991): 66-80
  9. "Product Information. Declomycin (demeclocycline)." Lederle Laboratories PROD (2001):
  10. Covington TR, eds., Lawson LC, Young LL "Handbook of Nonprescription Drugs." Washington, DC: American Pharmaceutical Association (1993):
  11. "Product Information. Suprep Bowel Prep Kit (magnesium/potassium/sodium sulfates)." Braintree Laboratories (2010):
  12. "Product Information. Seysara (sarecycline)." Allergan Inc (2018):
  13. "Product Information. Nuzyra (omadacycline)." Paratek Pharmaceuticals, Inc. (2018):
View all 13 references

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Drug and food interactions

Moderate

omadacycline food

Applies to: omadacycline

ADJUST DOSING INTERVAL: Administration with food, particularly dairy products, may reduce the absorption of omadacycline. The calcium content of these foods may form nonabsorbable chelates with omadacycline.

MANAGEMENT: Omadacycline should be administered at least 2 hours before (4 hours for dairy products) or 4 hours after meals.

References

  1. "Product Information. Nuzyra (omadacycline)." Paratek Pharmaceuticals, Inc. (2018):

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Moderate

diphenhydrAMINE food

Applies to: diphenhydramine / magnesium salicylate

GENERALLY AVOID: Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous. In addition, the potential for abuse may be increased with the combination. The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system. No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load. However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.

MANAGEMENT: Alcohol should generally be avoided during therapy with anticholinergic agents. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.

References

  1. Linnoila M "Drug effects on psychomotor skills related to driving: interaction of atropine, glycopyrrhonium and alcohol." Eur J Clin Pharmacol 6 (1973): 107-12

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Moderate

magnesium salicylate food

Applies to: diphenhydramine / magnesium salicylate

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

References

  1. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn PROD (2002):

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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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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