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 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.