Drug Interaction Report
1 potential interaction and/or warning found for the following 2 drugs:
- fosphenytoin
- troleandomycin
Interactions between your drugs
troleandomycin fosphenytoin
Applies to: troleandomycin, fosphenytoin
MONITOR: Coadministration with phenytoin may reduce the plasma concentrations and antimicrobial efficacy of erythromycin and other macrolide antibiotics. The mechanism is induction of CYP450 3A metabolism by phenytoin. Additionally, plasma concentrations of phenytoin may be increased. One study has suggested that the pharmacokinetic disposition of phenytoin is not significantly altered in patients receiving erythromycin. However, occasional large changes in phenytoin clearance were noted in some patients.
MANAGEMENT: If concomitant use is medically necessary, caution and monitoring for altered efficacy and safety of both medications is recommended.
References (5)
- Bachmann K, Schwartz JI, Forney RB Jr, Jauregui L (1984) "Single dose phenytoin clearance during erythromycin treatment." Res Commun Chem Pathol Pharmacol, 46, p. 207-17
- Milne RW, Coulthard K, Nation RL, et al. (1988) "Lack of effect of erythromycin on the pharmacokinetics of single oral doses of phenytoin." Br J Clin Pharmacol, 26, p. 330-3
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
- Cerner Multum, Inc. "Australian Product Information."
Drug and food interactions
No alcohol/food interactions were found with the drugs in your list. However, this does not necessarily mean no food interactions exist. Always consult your healthcare provider.
Therapeutic duplication warnings
No duplication 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
| 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. |
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