Drug Interaction Report

GENERALLY AVOID: Coadministration with antacids, H2-receptor antagonists, proton pump inhibitors, or other agents with acid neutralizing or reducing effects may decrease the oral bioavailability and plasma concentrations of ampicillin from bacampicillin. The exact mechanism of interaction is unknown but may be related to degradation of the prodrug when gastric pH is increased.

MANAGEMENT: The possibility of a reduced or subtherapeutic response to bacampicillin should be considered during coadministration with antacids, H2-receptor antagonists, proton pump inhibitors, or other agents that can increase gastric pH. Preferably, these agents should be avoided during therapy with bacampicillin, or an alternative antibiotic be prescribed if these medications cannot be discontinued. Patients treated with antacids (or oral medications that contain antacids such as didanosine buffered tablets or pediatric oral solution) may minimize the effects of the interaction with bacampicillin by separating the times of administration by at least 2 hours.

ADJUST DOSING INTERVAL: Food may interfere with the absorption of esomeprazole. The manufacturer reports that the area under the concentration-time curve for esomeprazole following a single 40 mg dose was 33% to 53% lower when administered after food intake as opposed to during fasting conditions.

MANAGEMENT: Esomeprazole should be taken at least one hour before meals. When administered to patients receiving continuous enteral nutrition, some experts recommend that the tube feeding should be interrupted for at least 1 hour before and 1 hour after the dose of esomeprazole is given.