Drug Interaction Report
4 potential interactions and/or warnings found for the following 2 drugs:
- ampicillin / probenecid
- avibactam / aztreonam
Interactions between your drugs
probenecid avibactam
Applies to: ampicillin / probenecid, avibactam / aztreonam
GENERALLY AVOID: Coadministration with probenecid may increase the plasma concentrations of avibactam. The proposed mechanism is probenecid inhibition of OAT1 and OAT3 transporters, which may contribute to the active uptake of avibactam from the blood compartment for excretion. In vitro, probenecid has been reported to inhibit OAT uptake of avibactam by 56% to 70%. Therefore, probenecid has the potential to decrease the elimination of avibactam during coadministration.
MANAGEMENT: Due to a lack of clinical data, concomitant use of avibactam with probenecid is not recommended.
References (3)
- (2015) "Product Information. Avycaz (avibactam-ceftazidime)." Forest Pharmaceuticals
- (2024) "Product Information. Emblaveo (avibactam-aztreonam)." Pfizer Ltd, EB 1_2
- (2025) "Product Information. Emblaveo (avibactam-aztreonam)." AbbVie US LLC
ampicillin probenecid
Applies to: ampicillin / probenecid, ampicillin / probenecid
Probenecid may increase the plasma concentrations and half-lives of penicillins. The mechanism is competitive inhibition by probenecid of the renal tubular secretion of penicillins. While this interaction is often exploited to enhance the antibacterial effect of penicillins, toxicity may occur and should be considered if high penicillin dosages are administered intravenously.
References (6)
- Sommers DK, Schoeman HS (1987) "Drug interactions with urate excretion in man?" Eur J Clin Pharmacol, 32, p. 499-502
- Waller ES, Sharanevych MA, Yakatan GJ (1982) "The effect of probenecid on nafcillin disposition." J Clin Pharmacol, 22, p. 482-9
- Shanson DC, McNabb R, Hajipieris P (1984) "The effect of probenecid on serum amoxycillin concentrations up to 18 hours after a single 3g oral dose of amoxycillin: possible implications for preventing endocarditis." J Antimicrob Chemother, 13, p. 629-32
- Sutherland R, Croydon EA, Rolinson GN (1972) "Amoxycillin: a new semi-synthetic penicillin." Br Med J, 3, p. 13-6
- Allen MB, Fitzpatrick RW, Barratt A, Cole RB (1990) "The use of probenecid to increase the serum amoxycillin levels in patients with bronchiectasis." Respir Med, 84, p. 143-6
- Gibaldi M, Schwartz MA (1968) "Apparent effect of probenecid on the distribution of penicillins in man." Clin Pharmacol Ther, 9, p. 345-9
probenecid aztreonam
Applies to: ampicillin / probenecid, avibactam / aztreonam
Coadministration of probenecid or furosemide with aztreonam results in clinically insignificant increases in aztreonam's systemic exposure. The proposed mechanism relates to inhibition of organic anion transporters 1 and 3 (OAT1, OAT3) by probenecid and furosemide, which may contribute to the active uptake of aztreonam from the blood compartment for excretion. The manufacturer does not recommend additional monitoring.
References (3)
- (2023) "Product Information. Azactam (aztreonam)." Bristol-Myers Squibb Pharmaceuticals Ltd
- (2022) "Product Information. Aztreonam (aztreonam)." Fresenius Kabi USA, LLC
- (2023) "Product Information. Azactam (aztreonam)." Bristol-Myers Squibb Australia Pty Ltd, 8
Drug and food interactions
ampicillin food
Applies to: ampicillin / probenecid
ADJUST DOSING INTERVAL: Certain penicillins may exhibit reduced gastrointestinal absorption in the presence of food. The therapeutic effect of the antimicrobial may be reduced.
MANAGEMENT: The interacting penicillin should be administered one hour before or two hours after meals. Penicillin V and amoxicillin are not affected by food and may be given without regard to meals.
References (6)
- Neu HC (1974) "Antimicrobial activity and human pharmacology of amoxicillin." J Infect Dis, 129, s123-31
- Welling PG, Huang H, Koch PA, Madsen PO (1977) "Bioavailability of ampicillin and amoxicillin in fasted and nonfasted subjects." J Pharm Sci, 66, p. 549-52
- McCarthy CG, Finland M (1960) "Absorption and excretion of four penicillins." N Engl J Med, 263, p. 315-26
- Cronk GA, Wheatley WB, Fellers GF, Albright H (1960) "The relationship of food intake to the absorption of potassium alpha-phenoxyethyl penicillin and potassium phenoxymethyl penicillin from the gastrointestinal tract." Am J Med Sci, 240, p. 219-25
- Klein JO, Sabath LD, Finland M (1963) "Laboratory studies on oxacillin. I: in vitro activity against staphylococci and some other bacterial pathogens. II: absorption and urinary excretion in normal young." Am J Med Sci, 245, p. 399-411
- Neuvonen PJ, Elonen E, Pentikainen PJ (1977) "Comparative effect of food on absorption of ampicillin and pivampicillin." J Int Med Res, 5, p. 71-6
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.
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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