تداخلات أوميبرازول وبيكربونات الصوديوم

Atazanavir : Avoid concomitant use with KONVOMEP. (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

For proton pump inhibitors, avoid concomitant use if possible. (نشرة إرلوتينيب، التداخلات الدوائية)

Avoid the use of calcium supplements, including calcium-based nonprescription antacids, concurrently with calcium acetate capsules. (نشرة أسيتات الكالسيوم، التحذيرات والاحتياطات)

• Gastric Acid Reducing Agents: Avoid co-administration with proton pump inhibitors (PPIs). (نشرة أكالابروتينيب، التداخلات الدوائية)

Take ALVAIZ at least 2 hours before or 4 hours after any medications or products containing polyvalent cations, such as antacids, dairy products, and mineral supplements to avoid significant reduction in absorption of ALVAIZ due to chelation [see Dosage and Administration ( 2.4 ), Clinical Pharmacology ( 12.3 )] . (نشرة إلترومبوباغ، التداخلات الدوائية)

Proton pump inhibitors (PPIs), including KONVOMEP, are contraindicated in patients receiving rilpivirine containing products [see Drug Interactions ( 7 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، موانع الاستعمال)

• that mineral supplements, vitamins with iron or minerals, calcium-, aluminum- or magnesium-based antacids, sucralfate or didanosine chewable/buffered tablets or the pediatric powder for oral solution should not be taken within the two-hour period before or within the two-hour period after taking ofloxacin (see Drug Interactions ) • that ofloxacin can be taken… (نشرة أوفلوكساسين، الاحتياطات)

It is recommended to avoid concurrent administration of ethambutol with aluminum hydroxide containing antacids for at least 4 hours following ethambutol administration. (نشرة إيثامبوتول، التداخلات الدوائية)

Concomitant Use With Gastric Acid-Reducing Agents : Avoid concomitant use of VOTRIENT with gastric acid-reducing agents. (نشرة بازوبانيب، التداخلات الدوائية)

…change in bowel habits that lasts more than 2 weeks stomach pain, nausea or vomiting When using this product do not chew or crush tablet(s) do not use within 1 hour after taking an antacid or milk it may cause stomach discomfort, faintness, and cramps Stop use and ask a doctor if you have rectal bleeding or fail to have a bowel movement after use of a laxative. (نشرة بيساكوديل، التحذيرات)

Routine administration of BIXLENVO together with, or 2 hours after, antacids containing Al/Mg is not recommended. (نشرة بيكتيغرافير وإمتريسيتابين وتينوفوفير ألافيناميد، التداخلات الدوائية)

Consider increasing the omeprazole dose in patients whose symptoms are not well controlled; avoid use of more than 40 mg per day of omeprazole. (نشرة دارونافير، التداخلات الدوائية)

Antacids: Avoid concomitant use. (نشرة داساتينيب، التداخلات الدوائية)

Examples Magnesium-containing products such as antacids Intervention Avoid use of magnesium-containing products and doxercalciferol in patients on chronic renal dialysis. (نشرة دوكسيركالسيفيرول، التداخلات الدوائية)

Do not take Exjade with aluminum-containing antacid preparations. (نشرة ديفيراسيروكس، التداخلات الدوائية)

Intervention: Concomitant use of diclofenac sodium/misoprostol and magnesium-containing antacids is not recommended. (نشرة ديكلوفيناك وميزوبروستول، التداخلات الدوائية)

Concomitant administration of Risedronate sodium delayed-release and H 2 blockers or PPIs is not recommended. (نشرة ريزيدرونات، التداخلات الدوائية)

John’s Wort or Rifampin : Avoid concomitant use of KONVOMEP. (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Proton pump inhibitors (PPIs), including KONVOMEP, are contraindicated in patients receiving rilpivirine containing products [see Drug Interactions ( 7 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، موانع الاستعمال)

Antacids: Antacids such as aluminum hydroxide/magnesium hydroxide decrease riociguat absorption and should not be taken within 1 hour of taking Adempas [see Clinical Pharmacology (12.3) ]. (نشرة ريوسيغوات، التداخلات الدوائية)

Avoid use of Citalopram Capsules in CYP2C19 poor metabolizers, patients receiving concomitant cimetidine or another CYP2C19 inhibitor, patients with hepatic impairment, and patients who are greater than 60 years of age, because Citalopram Capsules are only available in a 30 mg dose strength and dosage adjustments are not possible [see Drug Interactions ( 7 ),… (نشرة سيتالوبرام، التحذيرات والاحتياطات)

Histamine-2 (H 2 ) antagonists and proton pump inhibitors should be avoided. (نشرة سيفوروكسيم، التداخلات الدوائية)

• Drugs Affecting Gastric pH: Avoid concomitant use of IRESSA with proton pump inhibitors, if possible. (نشرة غيفيتينيب، التداخلات الدوائية)

When using this product do not take more than directed do not take at the same time as aluminum or magnesium antacids do not take with fruit juices (see Directions) Stop use and ask a doctor if an allergic reaction to this product occurs. (نشرة فيكسوفينادين، التحذيرات)

Calcium carbonate, aluminum hydroxide, magnesium hydroxide Prevention or Management: Phenytoin and antacids should not be taken at the same time of day Antineoplastic agents (usually in combination) Bleomycin, carboplatin, cisplatin, doxorubicin, methotrexate Antiviral agents Fosamprenavir, nelfinavir, ritonavir Antiepileptic drugs Carbamazepine, vigabatrin Other… (نشرة فينيتوين، التداخلات الدوائية)

Magnesium-containing preparations (e.g., antacids) and calcitriol should not be used concomitantly in patients on chronic renal dialysis because such use may lead to the development of hypermagnesemia. (نشرة كالسيتريول، التحذيرات)

Interaction with Clopidogrel : Avoid concomitant use of KONVOMEP. (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

• Bile acid sequestering agents and aluminum-based antacids: Avoid concomitant use with CTEXLI. (نشرة كينوديول، التداخلات الدوائية)

Concomitant administration of these antacids with quinine sulfate should be avoided. (نشرة كينين، التداخلات الدوائية)

There is a potential for LANTHANUM CARBONATE to interact with compounds that bind to cationic antacids (i.e., aluminum-, magnesium-, or calcium-based); therefore, do not take such compounds within 2 hours of dosing with LANTHANUM CARBONATE. (نشرة لانثانوم، التداخلات الدوائية)

Intervention Concomitant use of methylphenidate extended-release orally disintegrating tablets with a gastric pH modulator (i.e., a H2-blocker or a proton pump inhibitor) is not recommended. (نشرة ميثيل فينيدات، التداخلات الدوائية)

Antacids Because the dissolution of the coating of the granules in APRISO capsules depends on pH, avoid co-administration of APRISO capsules with antacids [see Dosage and Administration (2) ] . (نشرة ميسالازين، التداخلات الدوائية)

Intervention: Concomitant administration of antacids such as magnesium oxide or aluminum hydroxide, and sucralfate with Naproxen Suspension is not recommended. (نشرة نابروكسين، التداخلات الدوائية)

Naproxen and esomeprazole magnesium delayed-release tablets are contraindicated in the following patients: • Known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to naproxen, esomeprazole magnesium, substituted benzimidazoles, or to any components of the drug product, including omeprazole. (نشرة نابروكسين وإيزوميبرازول، موانع الاستعمال)

If coadministration of nitrofurantoin with antacids containing magnesium trisilicate cannot be avoided, monitor for lack of efficacy [see Clinical Pharmacology (12.3) ]. (نشرة نيتروفورانتوين، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

When using KONVOMEP, consider alternative antiplatelet therapy [see Drug Interactions ( 7 ) and Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

• Strong Inhibitors of CYP2C19 : The recommended dosage is 50 mg once daily or 100 mg once daily for those patients who are not responding to 50 mg once daily. (نشرة أبروسيتينيب، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

When using KONVOMEP, consider alternative antiplatelet therapy [see Drug Interactions ( 7 ) and Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

When using KONVOMEP, consider alternative antiplatelet therapy [see Drug Interactions ( 7 ) and Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Drugs Dependent on Gastric pH for Absorption (e.g., iron salts, erlotinib, dasatinib, nilotinib, mycophenolate mofetil, ketoconazole/itraconazole) Clinical Impact: Omeprazole can reduce the absorption of other drugs due to its effect on reducing intragastric acidity. (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Alkalinizing agents (GI antacids and urinary): These agents increase blood levels of amphetamine. (نشرة أمفيتامين وديكستروأمفيتامين، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Patients taking concomitant CYP1A2 inducers (e.g., omeprazole) may need to have their dose titrated to compensate for the decrease in AGRYLIN exposure. (نشرة أناغريليد، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

When using KONVOMEP, consider alternative antiplatelet therapy [see Drug Interactions ( 7 ) and Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Proton Pump Inhibitors, H2-receptor Antagonists, or Antacids: may decrease bioavailability of MYCAPSSA and the MYCAPSSA dose may need to be increased (‎ 7 ). (نشرة أوكتريوتيد، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Inducers of CYP1A2 or Glucuronyl Transferase — Omeprazole and rifampin may cause an increase in olanzapine clearance. (نشرة أولانزابين، التداخلات الدوائية)

Agents that induce CYP1A2 or glucuronyl transferase enzymes, such as omeprazole and rifampin, may cause an increase in olanzapine clearance. (نشرة أولانزابين وفلوكسيتين، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Bone Fracture : Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist, or spine. (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Drugs Dependent on Gastric pH for Absorption (e.g., iron salts, erlotinib, dasatinib, nilotinib, mycophenolate mofetil, ketoconazole/itraconazole) Clinical Impact: Omeprazole can reduce the absorption of other drugs due to its effect on reducing intragastric acidity. (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

However, antacids can decrease the peak concentration reached by 15% to 20% but have no detectable effect on the time-to-peak. (نشرة إيتودولاك، التداخلات الدوائية)

Bone Fracture : Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist, or spine. (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Bone Fracture : Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist, or spine. (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

When using KONVOMEP, consider alternative antiplatelet therapy [see Drug Interactions ( 7 ) and Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Impact of Other Drugs on Propranolol CYP2D6, CYP1A2 and CYP2C19 Inhibitors: CYP2D6 inhibitors (e.g. bupropion, fluoxetine, paroxetine, quinidine), CYP1A2 inhibitors (e.g., ciprofloxacin, enoxamine, fluvoxamine) and CYP2C19 inhibitors (e.g., fluconazole, fluvoxamine, ticlopidine) increase exposure to propranolol when co-administered with INNOPRAN XL. (نشرة بروبرانولول، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

When using KONVOMEP, consider alternative antiplatelet therapy [see Drug Interactions ( 7 ) and Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

When using KONVOMEP, consider alternative antiplatelet therapy [see Drug Interactions ( 7 ) and Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Proton Pump Inhibitors (PPI) As an alternative to PPIs, use short-acting antacids or H2 blockers and separate dosing by more than 2 hours from BOSULIF dosing. (نشرة بوسوتينيب، التداخلات الدوائية)

Cation-Donating Antacids: may reduce the resin’s potassium exchange capability and increase risk of systemic alkalosis ( 7.2 ). (نشرة بوليستيرين سلفونات الصوديوم، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Antacids — Simultaneous administration of an antacid (magnesium hydroxide/aluminum hydroxide) and tadalafil reduced the apparent rate of absorption of tadalafil without altering exposure (AUC) to tadalafil. (نشرة تادالافيل، التداخلات الدوائية)

Tacrolimus Clinical Impact: Potential for increased exposure of tacrolimus, especially in transplant patients who are intermediate or poor metabolizers of CYP2C19. (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

…Multivitamins, or Dairy Products The absorption of bismuth subcitrate potassium, metronidazole and tetracycline hydrochloride may be reduced if administered with antacids containing aluminium, calcium, or magnesium; preparations containing iron, zinc, or sodium bicarbonate; or milk or dairy products due to the interaction between these products and tetracycline. (نشرة تحت سترات البزموت وميترونيدازول وتتراسيكلين، التداخلات الدوائية)

Exposure to trospium on average was comparable in the presence of and without antacid, however, some individuals demonstrated increases or decreases in trospium exposure in the presence of antacid. (نشرة تروسبيوم، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

In vivo studies with omeprazole, metabolized by CYP2C19 and CYP3A4, and simvastatin, metabolized by CYP3A4, showed up to a 28% and 57% decrease in exposure one week following a single dose of tocilizumab, respectively. (نشرة توسيليزوماب، التداخلات الدوائية)

…modification of XELJANZ/XELJANZ XR is recommended [see Dosage and Administration (2) , Clinical Pharmacology, Figure 3 (12.3) ] Moderate CYP3A4 Inhibitors Concomitantly Used with Strong CYP2C19 Inhibitors (e.g., fluconazole) Clinical Impact Increased exposure to tofacitinib Intervention Dosage modification of XELJANZ/XELJANZ XR is recommended [see Dosage and Administration… (نشرة توفاسيتينيب، التداخلات الدوائية)

When using KONVOMEP, consider alternative antiplatelet therapy [see Drug Interactions ( 7 ) and Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

When using KONVOMEP, consider alternative antiplatelet therapy [see Drug Interactions ( 7 ) and Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Antacid Clinical Impact: Concomitant ingestion of antacids containing magnesium hydroxide has been shown to significantly increase the rate and extent of mefenamic acid absorption [See Clinical Pharmacology ( 12.3 )] Intervention: Concomitant use of mefenamic acid and antacids is not generally recommended because of possible increased adverse events. (نشرة حمض الميفيناميك، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

…studies, administration of a hormonal contraceptive containing EE did not lead to any increase or only to a weak increase in plasma concentrations of CYP3A4 substrates (e.g., midazolam) while plasma concentrations of CYP2C19 substrates (e.g., omeprazole and voriconazole) and CYP1A2 substrates (e.g., theophylline and tizanidine) can have a weak or moderate increase. (نشرة دروسبيرينون وإيثينيل إستراديول، التداخلات الدوائية)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

CYP2C19 Substrates (e.g., clopidogrel, citalopram, cilostazol, phenytoin, diazepam) Clopidogrel Clinical Impact: Concomitant use of omeprazole 80 mg results in reduced plasma concentrations of the active metabolite of clopidogrel and a reduction in platelet inhibition [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

When using KONVOMEP, consider alternative antiplatelet therapy [see Drug Interactions ( 7 ) and Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Antacids Concomitant administration of antacids may reduce plasma levels of diflunisal. (نشرة ديفلونيزال، التداخلات الدوائية)

Drugs Dependent on Gastric pH for Absorption (e.g., iron salts, erlotinib, dasatinib, nilotinib, mycophenolate mofetil, ketoconazole/itraconazole) Clinical Impact: Omeprazole can reduce the absorption of other drugs due to its effect on reducing intragastric acidity. (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Proton Pump Inhibitors Time to maximum concentration (T max ) of amphetamine is decreased compared to when administered alone. (نشرة ديكستروأمفيتامين، التداخلات الدوائية)

Bone Fracture : Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist, or spine. (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Bone Fracture : Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist, or spine. (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Gefitinib Gefitinib exposure was reduced by 44% with the coadministration of ranitidine and sodium bicarbonate (dosed to maintain gastric pH above 5.0). (نشرة رانيتيدين، التداخلات الدوائية)

Table 6: Drug Interactions that Decrease the Efficacy of Rosuvastatin Tablets Antacids Prevention or Management In patients taking an antacid, administer rosuvastatin tablets at least 2 hours before the antacid. (نشرة روسوفاستاتين، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Drugs Dependent on Gastric pH for Absorption (e.g., iron salts, erlotinib, dasatinib, nilotinib, mycophenolate mofetil, ketoconazole/itraconazole) Clinical Impact: Omeprazole can reduce the absorption of other drugs due to its effect on reducing intragastric acidity. (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Clinical Effect/Recommendation Acid Reducing Agents: ↓ velpatasvir Velpatasvir solubility decreases as pH increases. (نشرة سوفوسبوفير وفيلباتاسفير، التداخلات الدوائية)

Drug(s) Affecting Pharmacokinetics of Ciprofloxacin Antacids, Sucralfate, Multivitamins and Other Products Containing Multivalent Cations (magnesium/aluminum antacids; polymeric phosphate binders (for example, sevelamer, lanthanum carbonate); sucralfate; Videx ® (didanosine) chewable/buffered tablets or pediatric powder; other highly buffered drugs; or products… (نشرة سيبروفلوكساسين، التداخلات الدوائية)

Drug Interactions Antacids Concomitant administration of high doses of antacids (sodium bicarbonate and aluminum hydroxide) or H 2 blockers reduces peak plasma levels by 24% to 42% and the extent of absorption by 27% to 32%, respectively. (نشرة سيفبودوكسيم، التداخلات الدوائية)

Drug Interactions: Antacids (Aluminum- or Magnesium-Containing): Concomitant administration of 300 mg cefdinir capsules with 30 mL Maalox ® TC suspension reduces the rate (C max ) and extent (AUC) of absorption by approximately 40%. (نشرة سيفدينير، التداخلات الدوائية)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

CYP2C19 Substrates (e.g., clopidogrel, citalopram, cilostazol, phenytoin, diazepam) Clopidogrel Clinical Impact: Concomitant use of omeprazole 80 mg results in reduced plasma concentrations of the active metabolite of clopidogrel and a reduction in platelet inhibition [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Maalox ® (aluminum hydroxide, magnesium hydroxide) The mean bioavailability of gabapentin was reduced by about 20% with concomitant use of an antacid (Maalox ® ) containing magnesium and aluminum hydroxides. (نشرة غابابنتين، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

…Warnings and Precautions ( 5 ) ] and limited in vitro data for CYP3A4, it appears that fluvoxamine inhibits several cytochrome P450 isoenzymes that are known to be involved in the metabolism of other drugs such as: CYP1A2 (e.g., warfarin, theophylline, propranolol, tizanidine), CYP2C9 (e.g., warfarin), CYP3A4 (e.g., alprazolam), and CYP2C19 (e.g., omeprazole). (نشرة فلوفوكسامين، التداخلات الدوائية)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Strong CYP2C19 Inhibitors Examples Proton pump inhibitors, selective serotonin reuptake inhibitors, benzodiazepines, antifungals Clinical Implications The concomitant use of ADDYI with strong CYP2C19 inhibitors may increase flibanserin exposure which may increase the risk of hypotension, syncope, and CNS depression. (نشرة فليبانسيرين، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Intervention: Voriconazole : Dosage adjustment of KONVOMEP is not usually required. (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Antacids In a clinical pharmacology study, coadministration of an antacid (aluminum hydroxide, magnesium hydroxide, and simethicone) with fosinopril reduced serum levels and urinary excretion of fosinoprilat as compared with fosinopril administrated alone, suggesting that antacids may impair absorption of fosinopril. (نشرة فوسينوبريل، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

This diagnosis should be considered if clinical symptoms consistent with cyanocobalamin deficiency are observed in patients treated with KONVOMEP. (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Co-administration of CYP2C19 inhibitors, such as omeprazole or fluvoxamine, with carisoprodol could result in increased exposure of carisoprodol and decreased exposure of meprobamate. (نشرة كاريزوبرودول، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

When using KONVOMEP, consider alternative antiplatelet therapy [see Drug Interactions ( 7 ) and Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Drug Interactions Antacids and kaolin: Antacids and kaolin can reduce absorption of chloroquine; an interval of at least 4 hours between intake of these agents and chloroquine should be observed. (نشرة كلوروكين، التداخلات الدوائية)

Drugs Dependent on Gastric pH for Absorption (e.g., iron salts, erlotinib, dasatinib, nilotinib, mycophenolate mofetil, ketoconazole/itraconazole) Clinical Impact: Omeprazole can reduce the absorption of other drugs due to its effect on reducing intragastric acidity. (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Drugs that alkalinize the urine ( carbonic-anhydrase inhibitors, sodium bicarbonate, thiazide diuretics ) reduce renal elimination of quinidine. (نشرة كينيدين، التداخلات الدوائية)

However, esomeprazole, a proton pump inhibitor, administered at a dose of 40 mg once daily for 7 days, did not result in a clinically meaningful reduction in lapatinib steady-state exposure. (نشرة لاباتينيب، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Bone Fracture : Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist, or spine. (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Concomitant Drug Class: Drug Name Effect on Concentration ↓ = decrease, ↑ = increase Clinical Comment tenofovir DF = tenofovir disoproxil fumarate Acid Reducing Agents: ↓ ledipasvir Ledipasvir solubility decreases as pH increases. (نشرة ليديباسفير وسوفوسبوفير، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Interacting Drug Interaction Multivalent cation-containing products including antacids, metal cations or didanosine Absorption of levofloxacin is decreased when the tablet or oral solution formulation is taken within 2 hours of these products. (نشرة ليفوفلوكساسين، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Interaction with Methotrexate : Concomitant use with PPIs may elevate and/or prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity. (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Drugs Dependent on Gastric pH for Absorption (e.g., iron salts, erlotinib, dasatinib, nilotinib, mycophenolate mofetil, ketoconazole/itraconazole) Clinical Impact: Omeprazole can reduce the absorption of other drugs due to its effect on reducing intragastric acidity. (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Antisecretory Drugs Omeprazole: In healthy volunteers receiving a single dose of 10 mg nifedipine, AUC and C max of nifedipine after pre-treatment with omeprazole 20 mg q.d. for 8 days were 1.26 and 0.87 times those after pre-treatment with placebo. (نشرة نيفيديبين، الاحتياطات)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Drugs Dependent on Gastric pH for Absorption (e.g., iron salts, erlotinib, dasatinib, nilotinib, mycophenolate mofetil, ketoconazole/itraconazole) Clinical Impact: Omeprazole can reduce the absorption of other drugs due to its effect on reducing intragastric acidity. (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Antacids and kaolin Antacids and kaolin can reduce absorption of chloroquine; an interval of at least 4 hours between intake of these agents and chloroquine should be observed. (نشرة هيدروكسي كلوروكين، التداخلات الدوائية)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

Warfarin Clinical Impact: Increased INR and prothrombin time in patients receiving PPIs, including omeprazole, and warfarin concomitantly. (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

False Positive Urine Tests for THC Clinical Impact: There have been reports of false positive urine screening tests for tetrahydrocannabinol (THC) in patients receiving PPIs. (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

مثبطات مضخة البروتون المتناولة لمدة سنة أو أكثر قد تسبب انخفاض المغنيسيوم؛ وقد لا تصحّحه المكملات ما دام مثبط مضخة البروتون (PPI) مستمرًا. (NIH Office of Dietary Supplements, Magnesium)

Calcium supplements, antacids or oral medications containing multivalent cations interfere with absorption of alendronate. (نشرة أليندرونات، التداخلات الدوائية)

Aluminum-based Antacids : May interfere with the action of URSO 250 and URSO Forte by reducing its absorption. (نشرة أورسوديول، التداخلات الدوائية)

Calcium supplements, antacids and some oral medications may interfere with absorption of ibandronate. (نشرة إيباندرونات، التداخلات الدوائية)

Avoid coadministration of XOFLUZA with dairy products, calcium-fortified beverages, polyvalent cation-containing laxatives, antacids, or oral supplements (e.g., calcium, iron, magnesium, selenium, or zinc). (نشرة بالوكسافير ماربوكسيل، التداخلات الدوائية)

…performed, the following concomitant drugs were used in at least 10% of patients in either or both Sjogren's efficacy studies: acetylsalicylic acid, artificial tears, calcium, conjugated estrogens, hydroxychloroquine sulfate, ibuprofen, levothyroxine sodium, medroxyprogesterone acetate, methotrexate, multivitamins, naproxen, omeprazole, paracetamol, and prednisone. (نشرة بيلوكاربين، التداخلات الدوائية)

Absorption of tetracyclines is impaired by antacids containing aluminum, calcium or magnesium and preparations containing iron, zinc, or sodium bicarbonate. (نشرة تتراسيكلين، التداخلات الدوائية)

False Positive Urine Tests for THC Clinical Impact: There have been reports of false positive urine screening tests for tetrahydrocannabinol (THC) in patients receiving PPIs. (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Absorption of tetracyclines, including doxycycline hyclate is impaired by antacids containing aluminum, calcium, or magnesium, bismuth subsalicylate and iron-containing preparations. (نشرة دوكسيسيكلين، التداخلات الدوائية)

Other Clinical Impact: There have been clinical reports of interactions with other drugs metabolized via the cytochrome P450 system (e.g., cyclosporine, disulfiram). (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

Antacids: interfere with the absorption of anticholinergic agents (7) (نشرة ديسيكلومين، التداخلات الدوائية)

Absorption of tetracyclines is impaired by antacids containing aluminum, calcium or magnesium, and by iron-containing preparations. (نشرة ديميكلوسيكلين، التداخلات الدوائية)

Other Concomitant Medications EVISTA can be concomitantly administered with ampicillin, amoxicillin, antacids, corticosteroids, and digoxin [see Clinical Pharmacology ( 12.3 )] . (نشرة رالوكسيفين، التداخلات الدوائية)

Drug Interactions Antacids The extent of absorption of cefaclor extended-release tablets is diminished if magnesium or aluminum hydroxide-containing antacids are taken within 1 hour of administration; H 2 blockers do not alter either the rate or the extent of absorption of cefaclor extended-release tablets. (نشرة سيفاكلور، التداخلات الدوائية)

Other Drug Interactions No pharmacokinetic interactions were observed between vardenafil and the following drugs: glyburide, warfarin, digoxin, an antacid based on magnesium-aluminum hydroxide, and ranitidine. (نشرة فاردينافيل، التداخلات الدوائية)

False Positive Urine Tests for THC Clinical Impact: There have been reports of false positive urine screening tests for tetrahydrocannabinol (THC) in patients receiving PPIs. (نشرة أوميبرازول وبيكربونات الصوديوم، التداخلات الدوائية)

The selective serotonin reuptake inhibitors sertraline (weak CYP3A4 inducer) and fluoxetine (CYP2D6 inhibitor), and the anti-epileptic drug felbamate (CYP2C19 inhibitor and CYP3A4 inducer) do not affect the pharmacokinetics of clonazepam. (نشرة كلونازيبام، التداخلات الدوائية)

It is possible that minor adverse symptoms of gastric intolerance may be prevented by administering Ketoprofen Capsules, USP with antacids, food, or milk. (نشرة كيتوبروفين، التحذيرات والاحتياطات)

Drug Interactions Results of preliminary studies in humans and rats suggest that nonabsorbable antacids given concurrently with lactulose may inhibit the desired lactulose-induced drop in colonic pH. (نشرة لاكتولوز، التداخلات الدوائية)

Concomitant administration with antacids may interfere with the absorption of methscopolamine bromide. (نشرة ميثسكوبولامين، التداخلات الدوائية)

In 12 healthy males, concomitantly administered antacid did not influence the pharmacokinetics of miglitol. (نشرة ميغليتول، التداخلات الدوائية)

Urine pH is altered by diet, drugs (e.g. carbonic anhydrase inhibitors, sodium bicarbonate) and clinical state of the patient (e.g. renal tubular acidosis or severe infections of the urinary tract). (نشرة ميمانتين، التداخلات الدوائية)

Urine pH is altered by diet, drugs (e.g., carbonic anhydrase inhibitors, sodium bicarbonate) and clinical state of the patient (e.g., renal tubular acidosis or severe infections of the urinary tract). (نشرة ميمانتين ودونيبيزيل، التداخلات الدوائية)

Antacids and Iron Preparations Absorption of tetracyclines is impaired by antacids containing aluminum, calcium or magnesium and iron-containing preparations. (نشرة مينوسيكلين، التداخلات الدوائية)

Drug interactions may occur when anticholinergics are used with the following medications: antacids, antidiarrheals (adsorbent), other anticholinergics, antimyasthenics, cyclopropane, haloperidol, ketoconazole, metoclopramide, opioid (narcotic) analgesics, and potassium chloride. (نشرة هيوسيامين، التداخلات الدوائية)

In addition, no dosage adjustment is necessary for substrates of CYP2D6 (e.g., dextromethorphan, fluoxetine, paroxetine, or venlafaxine), CYP2C9 (e.g., warfarin), CYP2C19 (e.g., omeprazole, warfarin), or CYP3A4 (e.g., dextromethorphan) when coadministered with ABILIFY MAINTENA. (نشرة أريبيبرازول، التداخلات الدوائية)

Effects of Concomitant Acid Blockers or Antibiotics A population pharmacokinetic analysis suggests that the pharmacokinetics of alvimopan were not affected by concomitant administration of acid blockers (proton pump inhibitors (PPIs), histamine-2 (H 2 ) receptor antagonists) or antibiotics. (نشرة ألفيموبان، التداخلات الدوائية)

…isradipine influenza vaccine ketoconazole lomefloxacin mebendazole medroxyprogesterone methylprednisolone metronidazole metoprolol nadolol nifedipine nizatidine norfloxacin ofloxacin omeprazole prednisone, prednisolone ranitidine rifabutin roxithromycin sorbitol (purgative doses do not inhibit theophylline absorption) sucralfate terbutaline, systemic terfenadine… (نشرة أمينوفيلين، التداخلات الدوائية)

…Clinically Significant Drug Interaction with TAMIFLU No dose adjustments are needed for either oseltamivir or the concomitant drug when coadministering oseltamivir with amoxicillin, acetaminophen, aspirin, cimetidine, antacids (magnesium and aluminum hydroxides and calcium carbonates), rimantadine, amantadine, or warfarin [see Clinical Pharmacology (12.3) ] . (نشرة أوسيلتاميفير، التداخلات الدوائية)

Drugs Having No Clinically Important Interactions with REXULTI Based on pharmacokinetic studies, no dosage adjustment of REXULTI is required when administered concomitantly with CYP2B6 inhibitors (e.g., ticlopidine) or gastric pH modifiers (e.g., omeprazole). (نشرة بريكسبيبرازول، التداخلات الدوائية)

Drugs Without Clinically Significant Interactions with Bortezomib No clinically significant drug interactions have been observed when bortezomib was coadministered with dexamethasone, omeprazole, or melphalan in combination with prednisone [see Clinical Pharmacology (12.3) ] . (نشرة بورتيزوميب، التداخلات الدوائية)

The following have no clinically relevant effects on the pharmacokinetics of amlodipine: cimetidine, grapefruit juice, magnesium and aluminum hydroxide antacid, sildenafil. (نشرة تيلميسارتان وأملوديبين، التداخلات الدوائية)

…atenolol metoprolol azithromycin nadolol caffeine, dietary ingestion nifedipine cefaclor nizatidine co-trimoxazole (trimethoprim and sulfamethoxazole) norfloxacin ofloxacin diltiazem omeprazole dirithromycin prednisone, prednisolone enflurane ranitidine famotidine rifabutin felodipine roxithromycin finasteride Sorbitol (purgative doses do not inhibit hydrocortisone… (نشرة ثيوفيلين، التداخلات الدوائية)

Drugs for which either no interaction or a likely clinically unimportant interaction has been observed Antacids A study involving the co-administration of valproate 500 mg with commonly administered antacids (Maalox, Trisogel, and Titralac - 160 mEq doses) did not reveal any effect on the extent of absorption of valproate. (نشرة حمض الفالبرويك، التداخلات الدوائية)

If a patient requires dofetilide and anti-ulcer therapy, it is suggested that omeprazole, ranitidine, or antacids (aluminum and magnesium hydroxides) be used as alternatives to cimetidine, as these agents have no effect on the pharmacokinetic profile of dofetilide. (نشرة دوفيتيليد، التداخلات الدوائية)

Antacid The co-administration of 30 mL of Maalox® with ziprasidone did not affect the pharmacokinetics of ziprasidone. (نشرة زيبراسيدون، التداخلات الدوائية)

Concomitant administration of 20 mg omeprazole did not affect the pharmacokinetics of cysteamine when PROCYSBI was administered with 240 mL of orange juice or with 240 mL of water [see Clinical Pharmacology (12.3) ]. (نشرة سيستيامين، التداخلات الدوائية)

The bioavailability of the capsule formulation of cefprozil was not affected when administered 5 minutes following an antacid. (نشرة سيفبروزيل، التداخلات الدوائية)

…Penciclovir No clinically significant alterations in penciclovir pharmacokinetics were observed following single-dose administration of 500 mg famciclovir after pretreatment with multiple doses of allopurinol, cimetidine, theophylline, zidovudine, promethazine, when given shortly after an antacid (magnesium and aluminum hydroxide), or concomitantly with emtricitabine. (نشرة فامسيكلوفير، التداخلات الدوائية)

Effects of Antacids on Felbatol ® The rate and extent of absorption of a 2400 mg dose of Felbatol ® as monotherapy given as tablets was not affected when coadministered with antacids. (نشرة فيلبامات، التداخلات الدوائية)

In bioavailability studies with normal subjects, the concurrent administration of antacids at therapeutic levels did not significantly influence the bioavailability of clorazepate dipotassium tablets. (نشرة كلورازيبات، التداخلات الدوائية)

Effect of Other Drugs on Micafungin in Sodium Chloride Injection CYP3A4, CYP2C9 and CYP2C19 Inhibitors Co-administration of Micafungin in Sodium Chloride Injection with cyclosporine, itraconazole, voriconazole and fluconazole did not alter the pharmacokinetics of micafungin. (نشرة ميكافونجين، التداخلات الدوائية)

Concomitant administration of an aluminum-containing antacid had no significant effect on the bioavailability of 6MNA. (نشرة نابوميتون، التداخلات الدوائية)