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Gemifloxacin Mesylate: Drug Interactions

Drugs that Prolong QT Interval Potential pharmacologic interaction (additive effect on QT interval prolongation).

Avoid concomitant use with class IA (e.g., quinidine, procainamide) or class III (e.g., amiodarone, sotalol) antiarrhythmic agents; use with caution in patients receiving erythromycin, antipsychotic agents, or tricyclic antidepressants.

Drugs Metabolized by Hepatic Microsomal Enzymes

Gemifloxacin is not an inhibitor of cytochrome P-450 (CYP) isoenzymes; pharmacokinetic interaction unlikely.

Antacids

Pharmacokinetic interaction (decreased absorption of gemifloxacin). Gemifloxacin should be taken at least 2 hours before or 3 hours after antacids that contain aluminum or magnesium. (See Dosage and Administration: Administration.) Antacids containing calcium or calcium supplements have no clinically important pharmacokinetic interaction with gemifloxacin.

Gemifloxacin Mesylate

Cimetidine Pharmacokinetic interaction (potential increase in serum gemifloxacin concentrations)

Not considered clinically important.

Didanosine Pharmacokinetic interaction; didanosine chewable/dispersible buffered tablets, buffered powder for oral solution, or pediatric powder for oral solution prepared as an admixture with antacid may substantially decrease gemifloxacin absorption. Gemifloxacin should be taken at least 2 hours before or 3 hours after these buffered didanosine preparations.

Digoxin

Pharmacokinetic interaction unlikely.

Iron, Multivitamins, and Mineral Supplements Pharmacokinetic interaction (decreased absorption of gemifloxacin).

Gemifloxacin should be taken at least 2 hours before or 3 hours after dietary supplements containing metal cations such as zinc, magnesium, or iron (e.g., multivitamins, ferrous sulfate).

Omeprazole

Pharmacokinetic interaction (potential increase in serum gemifloxacin concentrations)

not considered clinically important.

Oral Contraceptives Pharmacokinetic interaction (potential decrease in serum gemifloxacin concentrations);

not considered clinically important.

Probenecid Pharmacokinetic interaction (decreased clearance of gemifloxacin).

Sucralfate Pharmacokinetic interaction (decreased absorption of gemifloxacin).

Gemifloxacin should be taken at least 2 hours before sucralfate.

Theophylline Pharmacokinetic interaction unlikely.

Warfarin Pharmacologic interaction unlikely.

However, because some quinolones have been reported to enhance the effects of warfarin and its derivatives, prothrombin time or other suitable coagulation tests should be monitored closely if a quinolone anti-infective agent is administered with warfarin or its derivatives.

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