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Luai Al Bakour
El Temamy Pharmacy
Akoni Hijyen Teknolojileri Sanayi ve Dış Ticaret LTD. ŞTİ
Britton Chance Center for Biomedical Photonics
Arabian Trade Center - ATC
Medical Facility (32206):
Legality International. (Pvt.) Ltd.
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Spasmolytic-analgesic spasmodic syndromes of gastrointestinal, hepatobiliary, urinary, or genital.
Hypersensitivity to aminoglycosides Patients with tympanic membrane perforation or lack thereof.
Ascorbic acid: The use of vitamin C in doses of 4 grams a day or more, acidifies the urine pH below 6, the aminoglycosides are more active at an alkaline pH of 7-8, as acidification of the urine decreases therapeutic efficacy at the same urinal. It is recommended to consider this possibility in case of concomitant treatment and urinary tract infections. -Amphotericin B: esl simultaneous use of both drugs increases the risk of nephrotoxicity. It is suggested to monitor renal function parameters. "Oral anticoagulants: there has been increased anticoagulant effect (especially in patients receiving oral aminoglycosides), it is suggested to avoid the simultaneous use, but close monitoring of patients. Nonsteroidal anti-inflammatory: the use of nonsteroidal anti-inflammatory may decrease the excretion of aminoglycosides with increased risk of adverse effects. Monitor their appearance during combination therapy. "Bisphosphonates: Use of Gentamicicna hipocalcemiante can increase the effect of bisphosphonates. It is suggested to monitor the levels of calcium and magnesium in these patients. Neuromuscular blockers: the use of these drugs have been reported to increase the risk of paralysis and muscle weakness before the simultaneous use of aminoglycosides. It is suggested to avoid the use of these drugs, and if needed, performed under strict control of breathing. -Bumetanide: the simultaneous use of loop diuretics with aminoglycosides increases the risk of ototoxicity, renal failure increases the risk. Audiometric tests are suggested if needed regular treatment with both drugs. -Calcium: there is an increased risk of renal failure in patients receiving solutions containing high concentrations of calcium during heart surgery, due to enhancement of the adverse effect of aminoglycosides. Is suggested to avoid the administration of such solutions. -Cephalosporins: cephalosporin use concomitantly with aminoglycosides increases the risk of nephrotoxicity of both drugs. Although this interaction has been observed with cephalothin, suggested monitoring of renal function during treatment and avoid the simultaneous use in patients with renal insufficiency. -Cefotaxime: there has been an increase phosphatemia levels in the patients receiving cefotaxime or some of its metabolites after receiving gentamicin or tobramycin. We suggest monitoring serum phosphate levels during treatment and simultaneously suspend therapy if symptoms of hyperphosphatemia. "Cyclosporine: there is an increased risk of nephrotoxicity in patients receiving cyclosporine who are treated with aminoglycosides. It is suggested that strict monitoring of renal function and plasma levels of both drugs, if possible. Platinum-derivatives: the simultaneous use of aminoglycosides and platinum compounds increases the risk of ototoxicity. We suggest strictly monitored for signs of ototoxicity or use an alternative antibiotic. "Loop diuretics: there is an increased risk of adverse effects of aminoglycosides in patients using Gantamicina and loop diuretics. We suggest close monitoring of the patient to detect the occurrence of adverse effects. -Furosemide: there is an increased risk of nephrotoxicity and ototoxicity in patients receiving both drugs simultaneously. They have also been reported cases of alterations in plasma levels of gentamicin in these patients. It is suggested monitoring of renal function and, when necessary, monitoring levels of gentamicin. "Indomethacin: risk nefrotoxicdad increased by the use of both drugs. It is suggested that strict monitoring of renal function. "Magnesium: the use of salts of magnesium in patients treated with aminoglycosides increases the risk of neuromuscular weakness. It is suggested strict clinical monitoring of patients for the risk of respiratory dysfunction and apnea. -Penicillins: there is loss of effectiveness of the aminoglycoside when administered in conjunction with penicillin. It is assumed that the inactivation of aminoglycosides in vitro happens when you mix the two drugs, and in vivo in the case of patients with renal failure when the excretion of drugs is diminished. Aminoglycoside amikacin is the most stable in these cases. Avoid mixing the two drugs in the same solution. -Polygeline: An increase in the occurrence of renal failure seen in patients who are treated with aminoglycosides. We recommend close monitoring of renal function during treatment. "Quinine: there is an increased risk of neuromuscular blockade with simultaneous use of both drugs. Monitor respiratory function during combination therapy. "Succinylcholine: there is a greater neuromuscular blocking effect with the use of both drugs. We suggest close monitoring of ventilatory function of patients and careful titration of neuromuscular blocking doses. "Tacrolimus: the drug can cause kidney failure. Concomitant use may potentiate nephrotoxicity. It is suggested to monitor renal function concomitant administration of these drugs. "Vancomycin: there is a greater increase in the incidence of nephrotoxicity with concurrent use of both drugs, which is greater than each drug separately. It is suggested monitoring of renal function. "Zalcitabine: aminoglycosides can increase the risk of peripheral neurotoxicity Zalcitabine. We suggest close monitoring of the patient.
It is suggested to avoid the simultaneous use of other nephrotoxic or ototoxic drugs. Concomitant use of neuromuscular blockers. Simultaneous use of high efficiency diuretics (furosemide and the like). There are reports of neuromuscular blockade and respiratory paralysis. Patients with impaired neuromuscular transmission (myasthenia gravis). Renal insufficiency, vestibular or hearing prior. There is an increased risk of neurotoxicity in patients with electrolyte disturbances.
20 and 50 coated tablets.
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Samir Moussa M.D.
Dr. Tahsin Martini
Dr . Dirar Abboud
Dr. Hani Najjar
Dr. Samer Al-Jneidy
Yaser Habrawi , F.R.C.S.Ed
Dr. Talal Sabouni
Dr. Faisal Dibsi