Drug Interaction Report

ADJUST DOSING INTERVAL: Simultaneous administration of sucralfate may interfere with the absorption of tetracyclines and reduce their oral bioavailability. Sucralfate is an aluminum salt of a sulfated disaccharide. The aluminum moiety can dissociate at gastric pH and chelate with tetracyclines to form an insoluble complex that is poorly absorbed from the gastrointestinal tract. Reduced antibiotic efficacy may occur.

MANAGEMENT: To minimize the potential for interaction, tetracyclines should be administered at least 2 hours before sucralfate.

ADJUST DOSING INTERVAL: The administration of sucralfate with enteral nutrition may result in precipitation and the formation of bezoars that may obstruct feeding tubes. The proposed mechanism is the formation of an insoluble aluminum-protein complex between the aluminum in the sucralfate and the protein in the enteral feeding. In addition, sucralfate may not become activated due to the alkaline pH of enteral nutrition products.

MANAGEMENT: Some experts recommend separating the sucralfate doses from enteral feedings by at least 1 hour. Alternatively, consideration may be given to proton pump inhibitors or H2 antagonists.

ADJUST DOSING INTERVAL: Administration with food, particularly dairy products, may reduce the absorption of omadacycline. The calcium content of these foods may form nonabsorbable chelates with omadacycline.

MANAGEMENT: Omadacycline should be administered at least 2 hours before (4 hours for dairy products) or 4 hours after meals.