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Drug Interactions between Protostat and VP-GSTN

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

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Interactions between your drugs

Minor

metroNIDAZOLE genistein

Applies to: Protostat (metronidazole) and VP-GSTN (cholecalciferol / genistein / zinc glycinate)

Antibiotics may decrease the effects of soy isoflavones such as genistein and daidzein. Soy isoflavones are converted into their active forms in part by intestinal bacteria, thus alteration of the intestinal microflora by antibiotics may decrease availability of activated isoflavones. Data are limited. In a study consisting of 11 children ages 4 to 17 years who were fed a body weight-adjusted dose of soy nuts, the urinary excretion rates for genistein and all native isoflavones combined (i.e., genistein, daidzein, and glycitein) were reduced by 37% and 24%, respectively, during oral antibiotic treatment for infection compared to the healthy state when not on antibiotics. The urinary excretion rate for total isoflavones (i.e., native and activated isoflavones combined) was also reduced by 24% during antibiotic administration. The clinical significance of these changes is unknown. There was some indication that the infectious process itself may have played a role, either by altering the colonic flora or some other mechanism, although the extent is unclear.

References

  1. Therapeutic Research Faculty "Natural Medicines Comprehensive Database. http://www.naturaldatabase.com" (2008):
  2. Halm BM, Franke AA, Ashburn LA, Hebshi SM, Wilkens LR "Oral antibiotics decrease urinary isoflavonoid excretion in children after soy consumption." Nutr Cancer 60 (2008): 14-22

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Drug and food interactions

Major

metroNIDAZOLE food

Applies to: Protostat (metronidazole)

CONTRAINDICATED: Use of alcohol or products containing alcohol during nitroimidazole therapy may result in a disulfiram-like reaction in some patients. There have been a few case reports involving metronidazole, although data overall are not convincing. The presumed mechanism is inhibition of aldehyde dehydrogenase (ALDH) by metronidazole in a manner similar to disulfiram. Following ingestion of alcohol, inhibition of ALDH results in increased concentrations of acetaldehyde, the accumulation of which can produce an unpleasant physiologic response referred to as the 'disulfiram reaction'. Symptoms include flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, weakness, vertigo, blurred vision, and confusion. Severe reactions may result in respiratory depression, cardiovascular collapse, arrhythmia, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death. However, some investigators have questioned the disulfiram-like properties of metronidazole. One study found neither elevations in blood acetaldehyde nor objective or subjective signs of a disulfiram-like reaction to ethanol in six subjects treated with metronidazole (200 mg three times a day for 5 days) compared to six subjects who received placebo.

MANAGEMENT: Because clear evidence is lacking concerning the safety of ethanol use during nitroimidazole therapy, patients should be apprised of the potential for interaction. Consumption of alcoholic beverages and products containing propylene glycol is specifically contraindicated during and for at least 3 days after completion of metronidazole and benznidazole therapy according to their product labeling.

References

  1. Giannini AJ, DeFrance DT "Metronidazole and alcohol: potential for combinative abuse." J Toxicol Clin Toxicol 20 (1983): 509-15
  2. Alexander I "Alcohol-antabuse syndrome in patients receiving metronidazole during gynaecological treatment." Br J Clin Pract 39 (1985): 292-3
  3. Harries DP, Teale KF, Sunderland G "Metronidazole and alcohol: potential problems." Scott Med J 35 (1990): 179-80
  4. "Product Information. Flagyl (metronidazole)." Searle PROD (2001):
  5. Edwards DL, Fink PC, Van Dyke PO "Disulfiram-like reaction associated with intravenous trimethoprim-sulfamethoxazole and metronidazole." Clin Pharm 5 (1986): 999-1000
  6. Williams CS, Woodcock KR "Do ethanol and metronidazole interact to produce a disulfiram-like reaction?." Ann Pharmacother 34 (2000): 255-7
  7. Visapaa JP, Tillonen JS, Kaihovaara PS, Salaspuro MP "Lack of disulfiram-like reaction with metronidazole and ethanol." Ann Pharmacother 36 (2002): 971-4
  8. Krulewitch CJ "An unexpected adverse drug effect." J Midwifery Womens Health 48 (2003): 67-8
  9. "Product Information. Benznidazole (benznidazole)." Everett Laboratories Inc (2017):
View all 9 references

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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.

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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.

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