Drug Interaction Report

MONITOR: Tetracycline antibiotics may inhibit the metalloproteinase-mediated collagen degradation of collagenase clostridium histolyticum (CCH). There is not any clinical evidence of an interaction between CCH and tetracycline antibiotics in vivo. However, some sources report that tetracyclines have been shown to inhibit matrix metalloproteinase-mediated collagen degradation at pharmacologically relevant concentrations in vitro, while others report that this inhibition takes place at supra-pharmacological concentrations in vitro. There is also some research, using animal models, into the possibility of giving oral doxycycline prior to CCH-injections to help prevent skin injury.

MANAGEMENT: Collagenase clostridium histolyticum (CCH) should be used with caution in patients receiving tetracyclines as they could reduce the efficacy of CCH injections. Some authorities recommend not administering CCH to patients who have received tetracycline antibiotics within the previous 14 days.

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.