Tetracycline Digoxin

P-gp (ABCB1) Verapamil, digoxin, mitoxantrone, vinblastine, doxorubicin, losartan, talinolol, cortisol, dexamethasone, colchicine, loperamide, domperidone, indinavir, erythromycin, tetracycline, itraconazole, cyclosporine, methotrexate, amitryptyline, phenobarbital, morphine, cimetidine, and others... 

There is an increased risk of toxicity of MTX when administered with the NSAIDs, salicylates, oral antidiabetic drugs, phenytoin, tetracycline, and probenecid. There is an additive bone marrow depressant effect when administered with other drug known to depress the bone marrow or with radiation therapy. There is an increased risk for nephrotoxicity when MTX is administered with other drug that cause nephrotoxicity. When penicillamine is administered with digoxin, decreased blood levels of digoxin may occur. There is a decreased absorption of penicillamine when the dmg is administered with food, iron preparations, and 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. 

The effects of metoclopramide are antagonized by concurrent administration of anticholinergics or narcotic analgesics. Metoclopramide may decrease the absorption of digoxin and cimetidine and increase absorption of acetaminophen, tetracyclines, and levodopa Metoclopramide may alter die body s insulin requirements. 

Drugs that may affect ACEIs may include antacids, capsaicin, indomethacin, phenothiazines, probenecid, and rifampin. Drugs that may be affected by ACEIs include allopurinol, digoxin, lithium, potassium preparations/potassium-sparing diuretics, and tetracycline. 

Drugs that may be affected by tetracyclines include oral anticoagulants, digoxin, insulin, isotretinoin, methoxyflurane, oral contraceptives, penicillins, and theophyllines. 

Magnesium Oxide (Mag-Ox 400, Others) [OTC] [Antacid, Magnesium Supplement/Magnesium Salt] Uses R lace low Mg levels Action Mg supl Dose 400-800 mg/d daily-qid w/ full glass of HjO Caution [B, +] Contra UlcCTative colitis, diverticulitis, ileostomy/colostomy, heart block, renal insuff Disp Caps 140 mg tabs 400 mg (OTC) SE D, N Inter actions X Effects OF chlordiaz oxide, dicumarol, digoxin, indomethacin, INH, quinolones, tetracyclines EMS Monitor ECG for hypokalemia (flattened T waves) OD Unlikely to cause life-threatening Sxs, but may cause D, constipation, cramps, and abd pain symptomatic and supportive... 

Minocycline (Solodyn) [Antibiotic/Tetracycline] Uses Acne Action Tetracycline, bactmostatic Dose Adults Peds >12 y. 1 mg/kg PO daily X 12wk w/ food to -1- irritation Caution [C, ] assoc w/ pseudomembranous colitis w/ renal impair Contra AU gy, women of childbearing potential Disp Tabs SE D, HA, fevCT, rash, joint pain, fatigue, dizziness Interactions t Effects OF digoxin, oral anticoagulants t risk of n hrotox W/ methoxyflurane X effects W/... 

Certain drugs are excreted in urine only in small amounts but appear in high concentrations in the bile for example, erythromycin, novobiocin, tetracycline, phenolphthalein etc. The abnormality or any disease related to liver may impair bile secretion which can lead to the accumulation of certain drugs like probenecid, digoxin etc. This can also lead to decreased drug metabolism and decreased rates of secretion of drugs into bile. 

Side effects include dry mouth, constipation, nausea, vomiting, rash, pruritus, dizziness. It adsorbs and interferes with absorption of tetracycline, cimetidine, digoxin and phenytoin. 

Absorption of certain drugs, including those with neutral or cationic charge as well as anions, may be impaired by the resins. These include digitalis glycosides, thiazides, warfarin, tetracycline, thyroxine, iron salts, pravastatin, fluvastatin, folic acid, phenylbutazone, aspirin, and ascorbic acid. Any additional medication (except niacin) should be given 1 hour before or at least 2 hours after the resin to ensure adequate absorption. Colesevelam does not bind digoxin, warfarin, or reductase inhibitors. 

Cimetidine Phenytoin Ciprofloxacin Ranitidine Digoxin Tetracycline Norfloxacin Theophylline... 

Doxycydine (Adoxa, Periostal-, Oracea, Vibramycin, Vibra-Tabs) [Anribiotic/Tetracycline] Uses Broad-spectrum antibiotic acne vulgaris, uncomplicated GC, Chlamydia sp, PID, Lyme Dz, skin Infxns, anthrax, malaria prophylaxis Action Tetracycline bacteriostatic X- protein synth Dose Adults. 100 mg PO ql2h on 1st d, then 100 mg PO daily bid or 100 mg IV ql2h acne daily dosing, Chlamydia 7d, Lyme Dz 14—21 d, PID 14 d Peds >8 y 5 mg/kg/24 h PO, to a max of 200 mg/d - daily-bid Caution [D, +] Hepatic impair Contra Children <8 y, severe hepatic dysfxn Disp Tabs, caps, syrup, susp, inj SE D, GI disturbance, photosens Interactions T Effects OF digoxin, warfarin 1 effects W/ antacids, Fe, barbiturates, carbamazepine, phenytoins, food 4-effects OF penicillins EMS Monitor for signs of electrolyte disturbances and hypovolemia d/t D monitor for S/Sxs of super Infxn T risk of photosensitivity Rxns antibiotic of choice for the Tx and prophylaxis of anthrax exposure expired tetracyclines have been known to cause nephrotox OD May cause adverse GI effects symptomatic and supportive... 

Tetracycline Tetracycline injections have an acid pH. Incompatibility may reasonably be expected with alkaline preparations or with drugs unstable at low pH. Care should be taken when administering tetracyclines, since chelation takes place with metal ions. Tetracyclines interact with inorganic metal ions. They should not be used with drugs that cause hepatotoxicity and nephrotoxicity (e.g., digoxin, theophylline, ergot alkaloids, methotrexate, oral contraceptives, and penicillins). 

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