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Drug Interactions between mephenytoin and oritavancin

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

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Interactions between your drugs

Moderate

mephenytoin oritavancin

Applies to: mephenytoin and oritavancin

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with oritavancin may increase the plasma concentrations of drugs that are substrates of CYP450 2C9, and/or 2C19. The mechanism is decreased clearance due to inhibition of these isoenzymes by oritavancin. In a screening drug interaction study in 16 healthy volunteers, a single 1,200 mg dose of oritavancin increased the omeprazole-to-5-hydroxyomeprazole plasma ratio by 15% and the mean systemic exposure AUC of warfarin by 31%, indicating weak inhibition of CYP450 2C19 and CYP450 2C9, respectively.

MANAGEMENT: Caution is advised when oritavancin used concomitantly with drugs that are substrates of CYP450 2C9 and/or 2C19, particularly sensitive substrates, or those with a narrow therapeutic range. Dosage adjustments as well as closer clinical and laboratory monitoring for the development of adverse effects may be appropriate for some drugs whenever oritavancin is added to or withdrawn from therapy. Individual product labeling should be consulted for further guidance.

Drug and food interactions

Moderate

mephenytoin food

Applies to: mephenytoin

Mephenytoin levels may decrease when the suspension is given with enteral feedings. This could lead to a loss of seizure control. You could interrupt the feeding for 2 hours before and after the mephenytoin dose. Alternatively, you may give the mephenytoin suspension diluted in water and flush the tube with water after administration. These would make it easier for your body to absorb the medication. However, this still may not entirely avoid the interaction and may not always be feasible. You should have your mephenytoin levels checked upon starting and stopping of enteral feedings. In addition, using mephenytoin together with food may alter the effects of mephenytoin. Contact your doctor if you experience worsening of seizure control or symptoms of toxicity, including twitching eye movements, slurred speech, loss of balance, tremor, muscle stiffness or weakness, nausea, vomiting, feeling light-headed, fainting, and slow or shallow breathing. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Ask your doctor before making any changes to your therapy.

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.


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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.