Drug Interaction Report

ADJUST DOSING INTERVAL: Oral products containing zinc such as mineral supplements and multivitamins may interfere with the gastrointestinal absorption of cephalexin, ceftibuten or cephradine. In one pharmacokinetic study (n=12), concurrent administration of zinc sulfate (250 mg, single oral dose) and cephalexin (500 mg, single oral dose) decreased cephalexin maximum concentration (Cmax) and systemic exposure (AUC; 0-inf) by 31.05% and 27.4%, respectively. However, in the same study, when zinc sulfate was administered 3 hours after the cephalexin dose, no significant alteration in cephalexin pharmacokinetics were observed.

MANAGEMENT: Oral medications or mineral supplements that contain zinc are recommended to be administered at least 3 hours after the cephalexin, ceftibuten or cephradine dose.

ADJUST DOSING INTERVAL: Food reduces the oral absorption and bioavailability of ceftibuten. According to the product labeling, administration of ceftibuten oral suspension with a high-fat breakfast decreased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 26% and 17%, respectively. Administration of ceftibuten capsules with a standardized breakfast decreased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 18% and 8%, respectively.

MANAGEMENT: To ensure maximal oral absorption, ceftibuten oral suspension should be taken at least two hours before or one hour after a meal.