Corticosteroids Antacids

The following drugp have a decreased pharmacologic effect when administered with an antacid corticosteroids, digoxin, chlorpromazine, oral iron products, isoniazid, phenothiazines, ranitidine, phenytoin, valproic acid, and the tetracyclines. 

Drugs that may affect aspirin include activated charcoal, ammonium chloride, ascorbic acid or methionine, antacids and urinary alkalinizers, carbonic anhydrase inhibitors, corticosteroids, and nizatidine. Drugs that may be affected by aspirin include alcohol, ACE inhibitors, anticoagulants (oral), beta-adrenergic blockers, heparin, loop diuretics, methotrexate, nitroglycerin, NSAIDs, probenecid and sulfinpyrazone, spironolactone, sulfonylureas and exogenous insulin, and valproic acid. 

Drugs that may be affected by antacids include allopurinol, amphetamines, benzodiazepines, captopril, chloroquine, corticosteroids, dicumarol, diflunisal, digoxin, ethambutol, flecainide, fluoroquinolones, histamine H2 antagonists,... 

Drugs that may affect ketoconazole include antacids, didanosine, histamine H2 antagonists, isoniazid, sucralfate, proton pump inhibitors, and rifampin. Drugs that may be affected by ketoconazole include oral anticoagulants, corticosteroids, cyclosporine, protease inhibitors, tricyclic antidepressants, carbamazepine. 

Prednisolone [Corticosteroid] [See Steroids and Table VI-1] Interactions T Effects W/ clarithromycin, erythromycin, estrogen, ketoconazole, OCPs, troleandomycin X effects W/ antacids, aminoglutethimide, barbiturates, cholestyramine, colestipol, phenytoin, rifampin X effects OF anticoagulants, hypoglycemics, INH, salicylates, vaccine toxoids EMS Infxns may be masked OD May cause wt gain, T hair growth, acne, HTN, peripheral edema, and sore muscles symptomatic and supportive... 

Cascara Sagrada [Rhamnus purshiana) Uses Laxative Action Stimulates large intestine, T bowel motility propulsion Available forms Liq extract 1-5 mL PO OD Contra w/ PRG, lactation IBD Notes/SE N/V, abd cramps, urine discoloration, osteomalacia Interactions t Effects OF antiarrhyth-mics, cardiac glycosides T loss W/ diuretics, corticosteroids, cardiac glycosides effects W/ antacids, milk EMS Short-term use monitor ECG for hypokalemia (flattened T waves) d/t D caution w/ diuretics... 

Clinically important, potentially hazardous interactions with amoxicillin, ampicillin, antacids, bacampicillin, bismuth, calcium, carbenicillin, cloxacillin, corticosteroids, digoxin, iron, methoxyflurane, mezlocillin, nafcillin, oxacillin, penicillins, piperacillin, retinoids, ticarcillin, zinc... 

Clinically important, potentially hazardous interactions with acitretin, antacids, bexarotene, cholestyramine, co-trimoxazole, corticosteroids, fish oil supplements, minocycline, retinoids, tetracycline, vitamin A... 

Clinically important, potentially hazardous interactions with antacids, azathioprine, basiliximab, cholestyramine, corticosteroids, cyclophosphamide, cyclosporine, daclizumab, hemophilus B vaccine, mercaptopurine, metronidazole, norfloxacin, tacrolimus, vaccines... 

Clinically important, potentially hazardous interactions with amiodarone, amprenavir, anisindione, antacids, anticoagulants, aprepitant, atazanavir, atovaquone, beclomethasone, buprenorphine, corticosteroids, cortisone, cyclosporine, cyproterone, dabigatran, dapsone, darunavir, delavirdine, dexamethasone, dicumarol, digoxin, eszopiclone, flunisolide, fosamprenavir, gadoxetate, gestrinone, halothane, imatinib, isoniazid, itraconazole, ketoconazole, lapatinib, lorcainide, methylprednisolone, midazolam, nelfinavir, nifedipine, oral contraceptives, phenylbutazone, prednisone, protease inhibitors, pyrazinamide, ramelteon, ritonavir, saquinavir, solifenacin, sunitinib, tacrolimus, telithromycin, temsirolimus, tipranavir, tolvaptan, trabectedin, triamcinolone, triazolam, voriconazole, warfarin, zaleplon... 

Barbiturates, phenytoin, and rifampin may cause decreased paramethasone effects because of increased hepatic metabolism. Cholestyramine, colestipol, and antacids decrease the corticosteroid effect by absorbing the corticosteroid, decreasing the amount absorbed. 

Ammonium chloride and other urine acidifiers, as well as probenecid and sulfinpyrazone, increase salsalate blood levels. Antacids in high doses and other urine alkalizers decrease salsalate blood levels. Corticosteroids enhance salsalate elimination. Food and antacids delay and decrease absorption of salsalate. 

There is an increased risk of diarrhea in patients taking misoprostol with the m nesium-containing antacids. Sulfasalazine may increase the risk of toxicity of oral hypoglycemic dru, zidovudine, methotrexate, and phenytoin. There is an increased risk of crys-talluria when sulfasalazine is administered with medienamine. A decrease in the absorption of iron and folic acid may occur when these ents are administered with sulfasalazine. When bismuth subsalicylate is administered witli aspirin-containing dru, there is an increased risk of salicylate toxicity. There is an increased risk of toxicity of valproic acid and methotrexate and decreased effectiven s of the corticosteroids when these agents are administered with bismuth subsalicylate. 

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