Antacids Comb.
Adverse Effect: decreased pefloxacin effectiveness Clinical Management: Concurrent administration of pefloxacin and antacids is not recommended. If concurrent use cannot be avoided, pefloxacin should be taken at least two hours before or six hours after the antacid dose. Because staggered administration may not be completely reliable, aggressively monitor these patients for continued antibiotic efficacy.
Cimetidine
Adverse Effect: pefloxacin toxicity (nausea, disorientation, drowsiness) Clinical Management: Monitor for signs of pefloxacin toxicity (eg, nausea, disorientation, and drowsiness) and adjust the dose accordingly. If concurrent use cannot be avoided, select another H2-antagonist (eg, ranitidine or famotidine) that has less potential to alter drug metabolism.
Sucralfate
Adverse Effect: decreased pefloxacin effectiveness Clinical Management: Concurrent administration of pefloxacin and sucralfate is not recommended. If concurrent use cannot be avoided, norfloxacin should be taken at least two hours before or six hours after sucralfate.
Theophylline
Adverse Effect: an increased risk of theophylline toxicity (nausea, vomiting, palpitations, seizures) Clinical Management: Theophylline serum concentrations should be closely monitored when pefloxacin is added, discontinued, or when dosing changes occur. Dosing adjustments of theophylline may be necessary. |