Drug Interaction Report
2 potential interactions and/or warnings found for the following 2 drugs:
- Cotrim Pediatric (sulfamethoxazole / trimethoprim)
- Vivlodex (meloxicam)
Interactions between your drugs
sulfamethoxazole meloxicam
Applies to: Cotrim Pediatric (sulfamethoxazole / trimethoprim), Vivlodex (meloxicam)
MONITOR: Coadministration with inhibitors of CYP450 2C9 may increase the plasma concentration of meloxicam, which is a substrate of the isoenzyme.
MANAGEMENT: The potential for an interaction should be considered during concomitant use. It is recommended to monitor patients for NSAID-related side effects and toxicity. Dose adjustment of meloxicam may be warranted.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
Drug and food interactions
sulfamethoxazole food
Applies to: Cotrim Pediatric (sulfamethoxazole / trimethoprim)
MONITOR: Two cases have been reported in which patients on sulfamethoxazole-trimethoprim therapy, after consuming beer, reported flushing, heart palpitations, dyspnea, headache, and nausea (disulfiram - alcohol type reactions). First-generation sulfonylureas have been reported to cause facial flushing when administered with alcohol by inhibiting acetaldehyde dehydrogenase and subsequently causing acetaldehyde accumulation. Since sulfamethoxazole is chemically related to first-generation sulfonylureas, a disulfiram-like reaction with products containing sulfamethoxazole is theoretically possible. However, pharmacokinetic/pharmacodynamic data are lacking and in addition, the two reported cases cannot be clearly attributed to the concomitant use of sulfamethoxazole-trimethoprim and alcohol.
MANAGEMENT: Patients should be alerted to the potential for this interaction and although the risk for this interaction is minimal, caution is recommended while taking sulfamethoxazole-trimethoprim concomitantly with alcohol.
References
- Heelon MW, White M (1998) "Disulfiram-cotrimoxazole reaction." Pharmacotherapy, 18, p. 869-70
- Mergenhagen KA, Wattengel BA, Skelly MK, Clark CM, Russo TA (2020) "Fact versus fiction: a review of the evidence behind alcohol and antibiotic interactions." Antimicrob Agents Chemother, 64, e02167-19
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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