Drug Interaction Report

ADJUST DOSING INTERVAL: Concomitant use of some oral medications may reduce the bioavailability of orally administered iron, and vice versa.

Food taken in conjunction with oral iron supplements may reduce the bioavailability of the iron. However, in many patients intolerable gastrointestinal side effects occur necessitating administration with food.

MANAGEMENT: Ideally, iron products should be taken on an empty stomach (i.e., at least 1 hour before or 2 hours after meals), but if this is not possible, administer with meals and monitor the patient more closely for a subtherapeutic effect. Some studies suggest administration of iron with ascorbic acid may enhance bioavailability. In addition, administration of oral iron products and some oral medications should be separated whenever the bioavailability of either agent may be decreased. Consult the product labeling for specific separation times and monitor clinical responses as appropriate.

ADJUST DOSING INTERVAL: Food reduces the oral absorption and bioavailability of ceftibuten. According to the product labeling, administration of ceftibuten oral suspension with a high-fat breakfast decreased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 26% and 17%, respectively. Administration of ceftibuten capsules with a standardized breakfast decreased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 18% and 8%, respectively.

MANAGEMENT: To ensure maximal oral absorption, ceftibuten oral suspension should be taken at least two hours before or one hour after a meal.