Drug Interactions between methenamine and Prepopik
This report displays the potential drug interactions for the following 2 drugs:
- methenamine
- Prepopik (citric acid/magnesium oxide/sodium picosulfate)
Interactions between your drugs
methenamine magnesium oxide
Applies to: methenamine and Prepopik (citric acid/magnesium oxide/sodium picosulfate)
GENERALLY AVOID: Agents that can alkalinize the urine such as thiazide diuretics, carbonic anhydrase inhibitors, and antacids may decrease the antibacterial effectiveness of methenamine by inhibiting its conversion to formaldehyde. Methenamine is most effectively converted in an acidic milieu of pH less than 5.5.
MANAGEMENT: Concomitant use of methenamine-containing preparations with thiazide diuretics, carbonic anhydrase inhibitors, or large doses of antacids should be avoided if possible. Otherwise, frequent urine pH testing may be considered. Some methenamine products may be used with antacids if dosing times are separated by at least one hour. Consult the manufacturer's product labeling for specific recommendations.
References
- Musher D, Griffith D (1974) "Generation of formaldehyde from methenamine: effect of pH and concentration, and antibacterial effect." Antimicrob Agents Chemother, 6, p. 708-11
- Kevorkian C, Merritt J, Ilstrup D (1984) "Methenamine mandelate with acidification: an effective urinary antiseptic in patients with neurogenic bladder." Mayo Clin Proc, 59, p. 523
- (2002) "Product Information. Hiprex (methenamine)." Hoechst Marion Roussel
- Sand TE, Jacobsen S (1981) "Effect of urine pH and flow on renal clearance of methotrexate." Eur J Clin Pharmacol, 19, p. 453-6
- (2016) "Product Information. Hyophen (benzoic acid/hyoscy/methen/mblue/phenylsal)." BioComp Pharma
methenamine sodium picosulfate
Applies to: methenamine and Prepopik (citric acid/magnesium oxide/sodium picosulfate)
GENERALLY AVOID: Theoretically, use of sodium picosulfate during or following antibiotic treatment may result in a reduced laxative effect of sodium picosulfate. The proposed mechanism involves antibiotic-induced reduction of colonic bacteria that hydrolyze sodium picosulfate, a prodrug, to its active metabolite bis-(p-hydroxyphenyl)-pyridyl-2-methane (BHPM), a compound that stimulates colonic peristalsis. The clinical significance of this effect remains unknown.
MANAGEMENT: Consider use of an alternate laxative in patients who have recently taken or are currently taking an antibiotic. If concomitant use is required, additional bowel cleansing and colonoscopy may be required.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- (2022) "Product Information. Prepopik (citric acid/Mg oxide/Na picosulfate)." Ferring Pharmaceuticals Inc
- Cerner Multum, Inc. (2015) "Canadian Product Information."
- (2022) "Product Information. Clenpiq (citric acid/Mg oxide/Na picosulfate)." Ferring Pharmaceuticals Inc
- (2018) MHRA. Medicines & Healthcare products Regulatory Agency (general site Reference) http://www.mhra.gov.uk/spc-pil/index.htm
Drug and food interactions
sodium picosulfate food
Applies to: Prepopik (citric acid/magnesium oxide/sodium picosulfate)
ADJUST DOSING INTERVAL: Bowel cleansing products can increase the gastrointestinal transit rate. Oral medications administered within one hour of the start of administration of the bowel cleansing solution may be flushed from the gastrointestinal tract and not properly absorbed.
MANAGEMENT: Patients should be advised that absorption of oral medications may be impaired during bowel cleansing treatment. Oral medications (e.g., anticonvulsants, oral contraceptives, antidiabetic agents, antibiotics) should not be administered during and within one hour of starting bowel cleansing treatment whenever possible. However, if concomitant use cannot be avoided, monitoring for reduced therapeutic effects may be advisable.
References
- "Product Information. Golytely (polyethylene glycol 3350 with electrolytes)." Braintree
- (2022) "Product Information. Prepopik (citric acid/Mg oxide/Na picosulfate)." Ferring 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
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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