Drug Interactions between Prevacid NapraPAC 500 and Raxar
This report displays the potential drug interactions for the following 2 drugs:
- Prevacid NapraPAC 500 (lansoprazole/naproxen)
- Raxar (grepafloxacin)
Interactions between your drugs
naproxen lansoprazole
Applies to: Prevacid NapraPAC 500 (lansoprazole / naproxen) and Prevacid NapraPAC 500 (lansoprazole / naproxen)
GENERALLY AVOID: Theoretically, proton pump inhibitors may decrease the gastrointestinal absorption of enteric-coated naproxen, which requires an acidic environment for dissolution. The proposed mechanism is an increase in gastric pH (i.e. decreased gastric acidity) induced by proton pump inhibitors. In patients treated with proton pump inhibitors, the possibility of a reduced or subtherapeutic response to enteric-coated naproxen should be considered.
MANAGEMENT: Concomitant use of these drugs is generally not recommended.
References
- "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc PROD (2002):
naproxen grepafloxacin
Applies to: Prevacid NapraPAC 500 (lansoprazole / naproxen) and Raxar (grepafloxacin)
MONITOR: Coadministration with nonsteroidal anti-inflammatory drugs (NSAIDs) may potentiate the risk of central nervous system toxicity sometimes associated with fluoroquinolone use. The interaction has been reported most often with enoxacin. It may occur with other fluoroquinolones as well, but is poorly documented. The exact mechanism of interaction is unknown. Some investigators suggest that the piperazine ring of fluoroquinolones may inhibit the binding of gamma-aminobutyric acid (GABA) to brain receptors and that NSAIDs may synergistically add to this effect. Patients with a history of seizures may be at greater risk.
MANAGEMENT: Clinical monitoring for signs of CNS stimulation such as tremors, involuntary muscle movements, hallucinations, or seizures is recommended if fluoroquinolone antibiotics are prescribed in combination with NSAIDs.
References
- Ball P "Ciprofloxacin: an overview of adverse experiences." J Antimicrob Chemother 18 (1986): 187-93
- Hooper DC, Wolfson JS "The fluoroquinolones: pharmacology, clinical uses, and toxicities in humans." Antimicrob Agents Chemother 28 (1985): 716-21
- "Product Information. Cipro (ciprofloxacin)." Bayer PROD (2002):
- "Product Information. Penetrex (enoxacin)." Rhone Poulenc Rorer PROD (2002):
- "Product Information. Floxin (ofloxacin)." Ortho McNeil Pharmaceutical PROD (2001):
- Domagala JM "Structure-activity and structure-side-effect relationships for the quinolone antibacterials." J Antimicrob Chemother 33 (1994): 685-706
- "Product Information. Levaquin (levofloxacin)." Ortho McNeil Pharmaceutical PROD (2001):
- "Product Information. Raxar (grepafloxacin)." Glaxo Wellcome PROD (2001):
- Davey PG "Overview of drug interactions with the quinolones." J Antimicrob Chemother 22(suppl c) (1988): 97-107
- Ball P, Tillotson G "Tolerability of fluoroquinolone antibiotics: past, present and future." Drug Saf 13 (1996): 343-8
- "Product Information. Avelox (moxifloxacin)." Bayer PROD (2001):
- "Product Information. Tequin (gatifloxacin)." Bristol-Myers Squibb PROD (2001):
- "Product Information. Factive (gemifloxacin)." *GeneSoft Inc (2003):
- Segev S. Rehavi M, Rubinstein E "Quinolones, theophylline, and diclofenac interactions with the gamma-aminobutyric acid receptor." Antimicrob Agents Chemother 32 (1988): 1624-6
lansoprazole grepafloxacin
Applies to: Prevacid NapraPAC 500 (lansoprazole / naproxen) and Raxar (grepafloxacin)
MONITOR: Based on in vitro inhibition data, coadministration with grepafloxacin may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. The mechanism is decreased clearance due to inhibition of CYP450 3A4 activity by grepafloxacin.
MANAGEMENT: Caution is advised if grepafloxacin must be used concurrently with medications that undergo metabolism by CYP450 3A4, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever grepafloxacin is added to or withdrawn from therapy.
References
- "Product Information. Raxar (grepafloxacin)." Glaxo Wellcome PROD (2001):
Drug and food interactions
naproxen food
Applies to: Prevacid NapraPAC 500 (lansoprazole / naproxen)
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
- "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn PROD (2002):
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.
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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