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Drug Interactions between Vantin and Virtrate-3

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

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Interactions between your drugs

Moderate

cefpodoxime sodium citrate

Applies to: Vantin (cefpodoxime) and Virtrate-3 (citric acid/potassium citrate/sodium citrate)

ADJUST DOSING INTERVAL: Coadministration with antacids or agents with acid-neutralizing effects may reduce the oral bioavailability of cefpodoxime proxetil and cefuroxime axetil. The proposed mechanism is a pH-dependent reduction in drug dissolution and absorption. In ten healthy volunteers, 10 mL of magnesium hydroxide-aluminum hydroxide (600 mg-900 mg) administered at 2 hours and at 15 minutes before the ingestion of cefpodoxime proxetil 200 mg led to an approximately 40% reduction in cefpodoxime peak plasma concentration (Cmax) and systemic exposure (AUC) compared to when the antibiotic was administered alone. Similar results were reported with sodium bicarbonate and aluminum hydroxide in another study. Likewise, pretreatment with ranitidine plus sodium bicarbonate decreased the Cmax and AUC of cefuroxime by over 40% in six healthy volunteers. The clinical significance of these effects is unknown, but potentially reduced antibiotic efficacy should be considered.

MANAGEMENT: Until further data are available, patients treated with cefpodoxime proxetil or cefuroxime axetil should avoid taking antacids or oral medications that contain antacids (e.g., didanosine buffered tablets or pediatric oral solution) for at least two hours before and after administration of the antibiotic.

References

  1. Saathoff N, Lode H, Neider K, et al. "Pharmacokinetics of cefpodoxime and interactions with an antacid and an H2 receptor antagonist." Antimicrob Agents Chemother 36 (1992): 796-800
  2. Hughes GS, Heald DL, Barker KB, et al. "The effects of gastric pH and food on the pharmacokinetics of a new oral cephalosporin, cefpodoxime proxetil." Clin Pharmacol Ther 46 (1989): 674-85
  3. Sommers DK, van Wyk M, Moncrieff J, Schoeman HS "Influence of food and reduced gastric acidity on the bioavailability of bacampicillin and cefuroxime axetil." Br J Clin Pharmacol 18 (1984): 535-9
  4. Honig PK, Gillespie BK "Clinical significance of pharmacokinetic drug interactions with over-the-counter (OTC) drugs." Clin Pharmacokinet 35 (1998): 167-71
View all 4 references

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Drug and food interactions

Moderate

cefpodoxime food

Applies to: Vantin (cefpodoxime)

ADJUST DOSING INTERVAL: Food enhances the oral bioavailability of cefpodoxime proxetil tablets. Following a 200 mg dose taken with food, the extent of absorption (mean AUC) was 21% to 33% higher and the mean peak plasma concentration (Cmax) 19% higher than under fasting conditions. Time to peak concentration (Tmax) was not significantly different between fed and fasted states. On the contrary, when a 200 mg dose of the suspension was taken with food, the mean AUC and Cmax were not significantly different than those under fasting conditions, although the rate of absorption was slower with food (48% increase in Tmax ).

MANAGEMENT: To ensure maximal oral absorption, cefpodoxime proxetil tablets should be administered with or immediately after a meal.

References

  1. Hughes GS, Heald DL, Barker KB, et al. "The effects of gastric pH and food on the pharmacokinetics of a new oral cephalosporin, cefpodoxime proxetil." Clin Pharmacol Ther 46 (1989): 674-85
  2. "Product Information. Vantin (cefpodoxime)." Pharmacia and Upjohn PROD
  3. Borin MT, Driver MR, Forbes KK "Effect of timing of food on absorption of cefpodoxime proxetil." J Clin Pharmacol 35 (1995): 505-9

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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.

Further information

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