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Some Common Arthritic Drugs that Are Contraindicated
for Use with Antibiotics
Methotrexate (MTX)
- increases gut permeability which is already a problem for many arthritics
- antibiotics destroy the gut flora which are necessary for breaking down MTX, increasing the possibility of liver toxicity in the patient
- effects of aspirin are potentiated by MTX, pancytopenia may occur
- CSA and MTX interfere with each others renal elimination, which may result in increased liver toxicity
- high doses of penicillins compete with MTX for transport and reduce renal tublular secretion.
Naprosyn
- blood thinners (Coumadin) or arthritismedicaitons.
- dose adjustment may be necessary if diuretics are being used concominantly
Methylprednisone
- contradinicated for use with aspirin, estrogen, diuretics, anticoagulants, erythromycin, diabetes drugs, arthritis medications
Antibiotics
- certain bacteriostatic antibiotics such as erythromycins & the tetracyclines inhibit protein synthesis and antagonize the bacteriostatic antibiotics (penicillins, cephalosporins) Tetrayclines can be used with penicillins if given as far apart as possible.
- inhibit theproduction of vitamin K by the intestinal flora by causing hyprothrombinemia, may lead to bleeding
Amoxicillin
- contraindicated for use with tetracyclines
Clindamycin (Cleocin)
- Clindamycin and erythromycin are antagonistic to each other
Erythromycin
- used in combination with non- sedating antihistamines such as Seldane or Hismanal can cause potentially fatal heartbeat abnormalities1
- contraindicated with cyclosporine
- antagonistic to lincomycin
Rifampin
- depresses the action of cortisone
Tetracyclines
- contraindicated with birth control pills and antacids
- use of metho- xyflurane anesthesia combined with tetracycline use may seriously impair renal function andlead to death. It potentiates the nephrotoxicity of the tetracyclines.
EDTA
- increases gastrointestinal absorption rate of certain antibiotics; may produce apnea and muscular weakness
References
Physician's Desk Reference
Table of Drug Interactions
Drug Information Handbook
1 Western Journal of Medicine (160:321, 94)
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