Metoprolol Antacids

Drugs that affect all phosphodiesterase type 5 inhibitors include the following alcohol, amlodipine, angiotensin II receptor blockers, antacids, bendroflumethiazide, beta blockers, cimetidine, diuretics, enalaphl, metoprolol, nifedipine, rifampin, tacrolimus. 

Drugs that may affect benzodiazepines include alcohol, antacids, barbiturates, cimetidine, disulfiram, fluoxetine, isoniazid, ketoconazole, metoprolol, oral contraceptives, narcotics, probenecid, propoxyphene, propranolol, ranitidine, rifampin, scopolamine, theophylline, and valproic acid. 

Ciprofloxacin (Cipro, Cipro XR, Proquin XR) [Antibiotic/ Fluoroquinolone] Uses Rx lower resp tract, sinuses, skin skin structure, bone/joints, urinary tract Infxns including prostatitis Action Quinolone antibiotic DNA gyrase Dose Adults. 250-750 mg PO ql2h XR 500-1000 mg PO q24h or 200-400 mg IV ql2h in renal impair Caution [C, /-] Children <18 y Contra Component sensitivity Disp Tabs, susp, inj SE Restlessness, N/V/D, rash, ruptured tendons, T LFTs Interactions T Effects Wf probenecid T effects OF diazepam, theophylline, caffeine, metoprolol, propranolol, phenytoin, warfarin effects W/ antacids, didanosine, Fe salts. Mg, sucralfate, Na bicarbonate,... 

BETA-BLOCKERS ANTACIDS CONTAINING MAGNESIUM AND ALUMINIUM t bioavailability of metoprolol and 1 bioavailability of atenolol, which may produce mild variation in the response to metoprolol and atenolol Variations in absorption of the respective beta-blockers Clinical significance may be minimal but be aware monitor BP at least weekly until stable when initiating antacid therapy. Warn patients to report symptoms of hypotension (light-headedness, dizziness on standing, etc.)... 

Some antacids and antidiarrhoeals may cause a modest reduction in the absorption of atenolol, indenolol, propranolol, or sotalol, and possibly a slight increase in the absorption of metoprolol. However, the clinical importance of these interactions is probably minimal. 

In 6 healthy subjects, 30 mL of Novalucolforte (an aluminium/magnesium-containing antacid) increased the peak plasma level and AUC of a single 100-mg dose of metoprolol by 25% and 11%, respectively. ... 

RegSrdh CG, Lundbo P, Persson B A The effect of antacid, metoclq>ramide and propantheline on die bioavailability of metoprolol and atenolol. Biopharm Drug Dispos (1981) 2,79-87. 

---