OBJECT DRUGS

Tetracyclines:

• Demeclocycline (Declomycin)
• Doxycycline (Vibramycin, etc.)
• Minocycline (Minocin, etc.)
• Oxytetracycline
• Tetracycline

PRECIPITANT DRUGS

Absorption Inhibitors:

• Antacids
• Bismuth (Pepto Bismol)
• Didanosine (Videx, etc.)
• Iron Products
• Sucralfate (Carafate)
• Zinc

Comment:

The absorption of tetracyclines may be reduced by agents containing cations such as aluminum, magnesium, and to a lesser extent, iron. Doxycycline may be less susceptible to these interactions than other tetracyclines, and does not appear to be affected significantly by iron.

Class 3: Assess Risk & Take Action if Necessary

• Circumvent/Minimize: Give the tetracycline 2 hours before or 6 hours after the absorption inhibitor to minimize the interaction. Enteric coated didanosine (Videx EC) does not appear to interact.
• Monitor: Watch for reduced tetracycline efficacy in patients taking absorption inhibitors.