Drug interactions alcohol

B) Acute alcohol withdrawal was precipitated by ciprofloxacin due to an alcohol-drug interaction. 

Adverse effect Hypoglycemia due to sulfonylureas Dose-relation toxic effect Time-course time-independent Susceptibility factors disease (impaired liver or kidney function, alcoholism) drug interactions reduced food intake exercise... 

Although ethanol is not metabolized by the microsomal drug-metabolizing system, it inhibits it and increases the rate of its synthesis. This effect may create a significant alcohol-drug interaction in both nonalcoholics and alcoholics who are taking medications. 

CaruUi N, Manenti F, Gallo M, Salvioli GF. Alcohol-drugs interaction in man alcohol and tolbutamide. EurJ Clin Invest ( 91 ) 1, 421-4. 

Monitor for drug interactions, including alcohol, at every visit. 

Evaluate for adverse effects and drug interactions. For patients on topical therapy, evaluate for local adverse effects. For patients on acetaminophen or NSAIDs, inquire about alcohol use. 

Although many patients believe that dietary supplements will not interact with medications, recent literature suggests otherwise. Recently, many St. John s wort-drug interactions have been reported in the literature. Cases of patients developing symptoms of serotonin syndrome have been reported with St. John s wort alone and in concomitant therapy with other antidepressants such as monoamine oxidase inhibitors, serotonin reuptake inhibitors, and venlafaxine. St. John s wort may exacerbate the sedative effects of benzodiazepines, alcohol, narcotics, and other sedatives. St. John s wort may decrease the levels of protease inhibitors, cyclosporine, digoxin, and theophylline. 

Drug interactions with the BZs are generally pharmacodynamic or pharmacokinetic (Table 68-11). The combination of BZs with alcohol or other CNS depressants may be fatal. 

Several factors predispose to lithium toxicity, including sodium restriction, dehydration, vomiting, diarrhea, drug interactions that decrease lithium clearance, heavy exercise, sauna baths, hot weather, and fever. Patients should be told to maintain adequate sodium and fluid intake and to avoid excessive coffee, tea, cola, and other caffeine-containing beverages and alcohol. 

Drug interactions with tizanidine hydrochloride include acetaminophen, alcohol, and oral contraceptives. 

The following drug interactions were reported for metronidazole, a chemically related nitroimidazole. Therefore, these drug interactions may occur with tinidazole. Drugs that may affect tinidazole include cholestyramine, CYP3A4 inducers and inhibitors and oxytetracycline. Drugs that may be affected by tinidazole include alcohols, anticoagulants, cyclosporine, tacrolimus, disulfiram, fluorouracil, hydantoins, and lithium. 

This chapter reviews the main mechanisms of drug interactions. It gives some clinically important examples of these, and suggests how they can be assessed and managed. It focuses on drug interactions that may have an adverse clinical outcome, rather than those that are used to therapeutic advantage. The issues of pharmaceutical incompatibility and drug interactions with food and alcohol will not be covered here. 

There are some clinically important pharmacodynamic drug-drug interactions to be mentioned. Antipsychotics will potentiate the central depressant effects of sedatives and of alcohol. They will also increase the risk of respiratory-depressant effects of opiates. Inducers of drug metabolic enzymes like for example rifampicin and several antiepileptics, may increase the elimination rate of antipsychotic agents and thus decrease their efficacy. 

Isoniazid (child 10 mg/kg up to) 300 mg orally, for 6 months 15 mg/kg orally, for 6 months 15 mg/kg orally, for 6 months Hepatic enzyme elevation Hepatitis Peripheral neuropathy CNS (mild) Drug interactions Hepatitis risk increases with age and alcohol consumption. Pyridoxine can prevent peripheral neuropathy... 

Multiple drug interactions including alcohol and salicylates... 

An excellent brief article on buprenorphine treatment has been provided by Taikato et al. (2005), which notes the common possible side-effects (headaches, nausea and vomiting, sweating, constipation, etc.) and drug interactions. The limited central depressant effect of buprenorphine may be compounded by alcohol and antidepressants, while the metabolism of buprenorphine can be enhanced by anticonvulsants, with therefore possibly reduced efficacy. There have been some case reports of liver toxicity from buprenorphine that is reversible if the medication is stopped (Herve et al. 2004), and often clinical guidelines will recommend that liver function tests are included in buprenorphine treatment, as they definitely should be with naltrexone. 

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