Drug Interaction Report

GENERALLY AVOID: Balsalazide may be rendered less effective when administered with certain antibiotics. Balsalazide is acted upon in the lower gut by bacterial azoreduction to produce mesalamine, the therapeutically active ingredient. Although no studies have been done, it is theorized that oral antibiotics can interfere with this reduction to mesalamine.

MANAGEMENT: If the patient must receive oral antibiotics, consideration should be given to using another 5-aminosalicylate such as mesalamine.

ADJUST DOSING INTERVAL: Food may reduce the oral absorption and bioavailability of levofloxacin. According to the drug product labeling, administration of levofloxacin 500 mg with food prolonged the time to peak concentration by 1 hour and decreased the Cmax decreased by 25% following administration of the oral solution and by 14% following administration of the oral tablet.

MANAGEMENT: To ensure maximal and consistent oral absorption, levofloxacin oral solution should be taken at least one hour before or two hours after meals. For administration of the oral solution with continuous enteral nutrition, some experts recommend that the tube feeding should be interrupted for one hour before and two hours after the dose of levofloxacin. The oral tablets may be taken without regard to food.