Drug Interaction Report

amphotericin B has a moderate potential interaction with Anemia.

Intravenous amphotericin B therapy may depress erythropoietin and red blood cell production and commonly causes a normocytic, normochromic anemia. Although the anemia is well tolerated by most patients and usually reverses completely within several months of stopping therapy, it may be problematic in patients with preexisting anemia. Intravenous therapy with amphotericin B should be administered cautiously in anemic patients or those predisposed to anemia. Frequent monitoring of blood counts and hemoglobin concentrations are recommended.

Pantoprazole has a major potential interaction with Diarrhea.

Published observational studies suggest that proton pump inhibitor (PPI) use may be associated with an increased risk of Clostridium difficile-associated diarrhea (CDAD), especially in hospitalized patients. This diagnosis should be considered for diarrhea that does not improve. It is recommended that patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated. Close monitoring is recommended in patients with diarrhea and in those taking antibacterial agents as CDAD has been reported with the use of nearly all these agents. Treatment with antibacterial agents alters the normal flora of the colon, leading to overgrowth of C. difficile. C. difficile produces toxins A and B, which contribute to the development of CDAD. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.

amphotericin B has a moderate potential interaction with Electrolyte Abnormalities.

Intravenously administered amphotericin B is nephrotoxic and may commonly cause hypo- or hyperkalemia, hypomagnesemia, and hypocalcemia secondary to renal impairment. Renal function and serum electrolytes should be closely monitored in all patients receiving intravenous therapy with amphotericin B, but in particular, those with preexisting renal and/or electrolyte abnormalities. Mineral and electrolyte supplementation is frequently required. Complications of electrolyte imbalances include muscle weakness, tetany, seizures and cardiac disturbances. Amphotericin B-related electrolyte abnormalities generally improve following cessation of therapy but may persist long after because of the drug's long terminal elimination half-life.

amphotericin B has a moderate potential interaction with Hyperkalemia.

Intravenously administered amphotericin B is nephrotoxic and may commonly cause hypo- or hyperkalemia, hypomagnesemia, and hypocalcemia secondary to renal impairment. Renal function and serum electrolytes should be closely monitored in all patients receiving intravenous therapy with amphotericin B, but in particular, those with preexisting renal and/or electrolyte abnormalities. Mineral and electrolyte supplementation is frequently required. Complications of electrolyte imbalances include muscle weakness, tetany, seizures and cardiac disturbances. Amphotericin B-related electrolyte abnormalities generally improve following cessation of therapy but may persist long after because of the drug's long terminal elimination half-life.

amphotericin B has a moderate potential interaction with Hypocalcemia.

Intravenously administered amphotericin B is nephrotoxic and may commonly cause hypo- or hyperkalemia, hypomagnesemia, and hypocalcemia secondary to renal impairment. Renal function and serum electrolytes should be closely monitored in all patients receiving intravenous therapy with amphotericin B, but in particular, those with preexisting renal and/or electrolyte abnormalities. Mineral and electrolyte supplementation is frequently required. Complications of electrolyte imbalances include muscle weakness, tetany, seizures and cardiac disturbances. Amphotericin B-related electrolyte abnormalities generally improve following cessation of therapy but may persist long after because of the drug's long terminal elimination half-life.

amphotericin B has a moderate potential interaction with Hypokalemia.

Intravenously administered amphotericin B is nephrotoxic and may commonly cause hypo- or hyperkalemia, hypomagnesemia, and hypocalcemia secondary to renal impairment. Renal function and serum electrolytes should be closely monitored in all patients receiving intravenous therapy with amphotericin B, but in particular, those with preexisting renal and/or electrolyte abnormalities. Mineral and electrolyte supplementation is frequently required. Complications of electrolyte imbalances include muscle weakness, tetany, seizures and cardiac disturbances. Amphotericin B-related electrolyte abnormalities generally improve following cessation of therapy but may persist long after because of the drug's long terminal elimination half-life.

Pantoprazole has a moderate potential interaction with Liver Disease.

Pantoprazole is primarily metabolized by the liver. In patients with mild to moderate hepatic impairment, little drug accumulation has been observed following once-daily, multiple-dose administration. No dosage adjustments are necessary in these patients. However, data are limited concerning the pharmacokinetic disposition of pantoprazole in patients with severe hepatic impairment. Alternate-day dosing may be appropriate in some cases.

amphotericin B has a moderate potential interaction with Magnesium Imbalance.

Intravenously administered amphotericin B is nephrotoxic and may commonly cause hypo- or hyperkalemia, hypomagnesemia, and hypocalcemia secondary to renal impairment. Renal function and serum electrolytes should be closely monitored in all patients receiving intravenous therapy with amphotericin B, but in particular, those with preexisting renal and/or electrolyte abnormalities. Mineral and electrolyte supplementation is frequently required. Complications of electrolyte imbalances include muscle weakness, tetany, seizures and cardiac disturbances. Amphotericin B-related electrolyte abnormalities generally improve following cessation of therapy but may persist long after because of the drug's long terminal elimination half-life.

Pantoprazole has a moderate potential interaction with Magnesium Imbalance.

Symptomatic and asymptomatic hypomagnesemia has been reported rarely in patients treated with PPIs for at least 3 months, in most cases after a year of therapy. Serious adverse events can include tetany, seizures, and arrhythmias. Caution should be used in patients prone to magnesium imbalances such as patients taking other medications that can cause hypomagnesemia (e.g., diuretics). Regular monitoring is recommended.

Pantoprazole has a moderate potential interaction with Osteoporosis.

Various published observational studies have reported that PPI therapy may be associated with an increased risk for osteoporosis related fractures of the hip, wrist or spine. The risk was increased in patients who received high doses (multiple daily doses), and long term treatment (a year or longer). Patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated. Caution should be used in patients at risk for osteoporosis related fractures and should be managed according to established treatment guidelines.

Pantoprazole has a major potential interaction with Pseudomembranous Colitis.

Published observational studies suggest that proton pump inhibitor (PPI) use may be associated with an increased risk of Clostridium difficile-associated diarrhea (CDAD), especially in hospitalized patients. This diagnosis should be considered for diarrhea that does not improve. It is recommended that patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated. Close monitoring is recommended in patients with diarrhea and in those taking antibacterial agents as CDAD has been reported with the use of nearly all these agents. Treatment with antibacterial agents alters the normal flora of the colon, leading to overgrowth of C. difficile. C. difficile produces toxins A and B, which contribute to the development of CDAD. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.

amphotericin B has a moderate potential interaction with Renal Dysfunction.

Intravenously administered amphotericin B is nephrotoxic and may commonly cause decreased renal function and abnormalities including azotemia, hypo- and hyperkalemia, hypomagnesemia, hyposthenuria, renal tubular acidosis, and nephrocalcinosis. Renal function should be closely monitored in all patients receiving intravenous therapy with amphotericin B but in particular, patients with preexisting renal impairment. Dosage reductions are recommended. Serum creatinine, BUN, potassium and magnesium levels should be evaluated frequently, and dosing adjusted or discontinued accordingly.