Drug Interaction Report

The following interaction applies only to products containing sodium biphosphate that are used for bowel cleansing. It does not apply to products containing sodium biphosphate that are used for other, non-laxative related purposes.

lomefloxacin can cause seizures and an irregular heart rhythm that may be serious and potentially life-threatening, although these are relatively rare side effects. The risk is increased if you have low blood levels of electrolytes such as calcium, magnesium, potassium or sodium, which can occur with bowel cleansing preparations or excessive use of medications that have a laxative effect. You should use sodium biphosphate exactly as prescribed by your doctor, and drink plenty of clear liquids before, during, and after the cleansing process to avoid becoming dehydrated. Your doctor may be able to recommend specific fluids you can drink before starting sodium biphosphate to help maintain your electrolyte levels. He/she may also want to monitor your electrolyte levels and/or heart rhythm. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications. In addition, you should let your doctor know if you experience signs and symptoms of low electrolyte levels such as weakness, tiredness, drowsiness, dizziness, confusion, tingling, numbness, muscle pain, cramps, nausea, or vomiting. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Oral medications may not be properly absorbed when they are taken within one hour before starting sodium biphosphate for bowel cleansing. Talk to your doctor or pharmacist to see if you should adjust the dosing schedule of your other medications before you begin bowel cleansing treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Consumer information for this interaction is not currently available.

GENERALLY AVOID: The oral bioavailability of quinolone and tetracycline antibiotics may be reduced by concurrent administration of preparations containing polyvalent cations such as aluminum, calcium, iron, magnesium, and zinc. Therapeutic failure may result. The proposed mechanism is chelation of quinolone and tetracycline antibiotics by di- and trivalent cations, forming an insoluble complex that is poorly absorbed from the gastrointestinal tract. Reduced gastrointestinal absorption of the cations should also be considered.

MANAGEMENT: Concomitant administration of oral quinolone and tetracycline antibiotics with preparations containing aluminum, calcium, iron, magnesium, and/or zinc salts should generally be avoided. Otherwise, the times of administration should be staggered by as much as possible to minimize the potential for interaction. Quinolones should typically be dosed either 2 to 4 hours before or 4 to 6 hours after polyvalent cation preparations, depending on the quinolone and formulation. Likewise, tetracyclines and polyvalent cation preparations should typically be administered 2 to 4 hours apart. The prescribing information for the antibiotic should be consulted for more specific dosing recommendations.