Skip to main content

Drug Interactions between isotretinoin and moxifloxacin / triamcinolone

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

Edit list (add/remove drugs)

Interactions between your drugs

Major

triamcinolone moxifloxacin

Applies to: moxifloxacin / triamcinolone and moxifloxacin / triamcinolone

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.

References (7)
  1. (2002) "Product Information. Cipro (ciprofloxacin)." Bayer
  2. (2001) "Product Information. Levaquin (levofloxacin)." Ortho McNeil Pharmaceutical
  3. (2001) "Product Information. Avelox (moxifloxacin)." Bayer
  4. Khaliq Y, Zhanel GG (2003) "Fluoroquinolone-Associated Tendinopathy: A Critical Review of the Literature." Clin Infect Dis, 36, p. 1404-1410
  5. van der Linden PD, Sturkenboom MC, Herings RM, Leufkens HM, Rowlands S, Stricker BH (2003) "Increased risk of achilles tendon rupture with quinolone antibacterial use, especially in elderly patients taking oral corticosteroids." Arch Intern Med, 163, p. 1801-7
  6. FDA. U.S. Food and Drug Administration (2008) Information for Healthcare Professionals. Fluoroquinolone Antimicrobial Drugs. FDA Alert [7/8/2008]. http://www.fda.gov/cder/drug/InfoSheets/HCP/fluoroquinolonesHCP.htm
  7. (2017) "Product Information. Baxdela (delafloxacin)." Melinta Therapeutics, Inc.
Moderate

triamcinolone ISOtretinoin

Applies to: moxifloxacin / triamcinolone and isotretinoin

MONITOR: Theoretical concerns exist that isotretinoin and corticosteroids may have additive effects on bone loss. Decreased bone mineral density (osteomalacia, osteopenia, osteoporosis) and bone fractures have been reported with either treatment alone during prolonged administration. Avascular necrosis has also been reported with corticosteroids, particularly when given in high dosages or for prolonged periods. However, no formal clinical trials have been conducted to evaluate whether there is an interactive effect on bone loss during coadministration.

MANAGEMENT: Caution is advised when isotretinoin is used in combination with corticosteroids, particularly in patients with a history of osteomalacia, osteoporosis, or other disorders of bone metabolism. Bone-related laboratory and radiological tests should be considered.

References (19)
  1. Need AG, Philcox JC, Hartley TF, Nordin BE (1986) "Calcium metabolism and osteoporosis in cortiscosteroid-treated postmenopausal women." Aust N Z J Med, 16, p. 341-6
  2. Mitchison HC, Bassendine MF, Malcolm AJ, et al. (1989) "A pilot, double-blind, controlled 1-year trial of prednisolone treatment in primary biliary cirrhosis: hepatic improvement but greater bone loss." Hepatology, 10, p. 420-9
  3. McCluskey J, Gutteridge DH (1982) "Avascular necrosis of bone after high doses of dexamethasone during neurosurgery." Br Med J (Clin Res Ed), 284, p. 333-4
  4. Anderton JM, Helm R (1982) "Multiple joint osteonecrosis following short-term steroid therapy. Case report." J Bone Joint Surg Am, 64, p. 139-41
  5. Taylor LJ (1984) "Multifocal avascular necrosis after short-term high-dose steroid therapy. A report of three cases." J Bone Joint Surg Br, 66, p. 431-3
  6. Fast A, Alon M, Weiss S, Zer-Aviv FR (1984) "Avascular necrosis of bone following short-term dexamethasone therapy for brain edema. Case report." J Neurosurg, 61, p. 983-5
  7. Black KA, Khangure MS, Owen ET (1981) "Dexamethasone and osteonecrosis." Aust N Z J Med, 11, p. 521-5
  8. Sambrook PN, Hassall JE, York JR (1984) "Osteonecrosis after high dosage, short term corticosteroid therapy." J Rheumatol, 11, p. 514-6
  9. Archer AG, Nelson MC, Abbondanzo SL, Bogumill GP (1989) "Case report 554: Osteonecrosis at multiple sites as noted." Skeletal Radiol, 18, p. 380-4
  10. Williams IA, Mitchell AD, Rothman W, Tallett P, Williams K, Pitt P (1988) "Survey of the long term incidence of osteonecrosis of the hip and adverse medical events in rheumatoid arthritis after high dose intravenous methylprednisolone." Ann Rheum Dis, 47, p. 930-3
  11. Bijlsma JW, Duursma SA, Bosch R, Raymakers JA, Huber-Bruning O (1988) "Acute changes in calcium and bone metabolism during methylprednisolone pulse therapy in rheumatoid arthritis." Br J Rheumatol, 27, p. 215-9
  12. Mizuta H, Kubota K, Shiraishi M, Kai K, Nakamura E, Takagi K (1993) "Steroid-related bilateral osteonecrosis of the patella." Arthroscopy, 9, p. 114-6
  13. (2001) "Product Information. Accutane (isotretinoin)." Roche Laboratories
  14. Marystone JF, Barrettconnor EL, Morton DJ (1995) "Inhaled and oral corticosteroids: their effects on bone mineral density in older adults." Am J Public Health, 85, p. 1693-5
  15. Packe GE, Douglas JG, McDonald AF, Robins SP, Reid DM (1992) "Bone density in asthmatic patients taking high dose inhaled beclomethasone diproprionate and intermittent systemic corticosteroids." Thorax, 47, p. 414-7
  16. Cruess RL (1978) "Experience with steroid-induced avascular necrosis of the shoulder and etiologic considerations regarding osteonecrosis of the hip." Clin Orthop, Jan-Feb(13, p. 86-93
  17. Saisu T, Sakamoto K, Yamada K, Kashiwabara H, Yokoyama T, Iida S, Harada Y, Ikenoue S, Sakamoto M, Moriya H (1996) "High incidence of osteonecrosis of femoral head in patients receiving more than 2 g of intravenous methylprednisolone after renal transplantation." Transplant Proc, 28, p. 1559-60
  18. Ledford D, Apter A, Brenner AM, Rubin K, Prestwood K, Frieri M, Lukert B (1998) "Osteoporosis in the corticosteroid-treated patient with asthma." J Allergy Clin Immunol, 102, p. 353-62
  19. Goldstein MF, Fallon JJ, Harning R (1999) "Chronic glucocorticoid therapy-induced osteoporosis in patients with obstructive lung disease." Chest, 116, p. 1733-49

Drug and food interactions

Moderate

ISOtretinoin food

Applies to: isotretinoin

GENERALLY AVOID: The combined use of ethanol and isotretinoin may result in a disulfiram-like reaction. The mechanism has not been established.

MANAGEMENT: Alcohol consumption should be avoided during isotretinoin therapy.

References (1)
  1. (2001) "Product Information. Accutane (isotretinoin)." Roche Laboratories

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

Report options

Loading...
QR code containing a link to this page

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.

Medical Disclaimer