Interactions : אינטראקציות

4.5 Interaction with other medicinal products and other forms of interaction
Anticoagulants
Plasma prothrombin activity is depressed by tetracyclines. Reduced doses of any concomitant anticoagulants may be necessary.

ACE inhibitors, antacids and adsorbants
Tetracyclines bind to di-/tri-valent cations. Absorption from the gastrointestinal tract is impaired by the concomitant administration of iron, calcium, aluminium, magnesium bismuth and zinc salts (interactions with specified salts, antacids, kaolin, bismuth containing ulcer-healing drugs, quinapril which contains a magnesium carbonate excipient). Dosages should be maximally separated. Absorption of tetracyclines is not significantly impaired by food, milk and milk products.

Diuretics
Diuretics may aggravate nephrotoxicity by volume depletion.

Antibacterials
Minocycline should not be used with penicillins.
Ergotamine and ergometrine
There is an increased risk of ergotism.

Oral Contraceptives
Both can induce hyperpigmentation.

Retinoids
Administration of isotretinoin should be avoided shortly before, during and shortly after minocycline therapy. Each drug alone has been associated with pseudotumor cerebri (benign intracranial hypertension) (see section 4.4).

Ulcer healing Drugs – absorption of minocycline decreased by sucralfate.

Laboratory tests
Minocycline may affect urinary urobilinogen excretion tests by reducing bacterial converters of bilirubin to urobilinogen. Minocycline may also produce an interference fluorescence in the Hungarty methods for measuring urinary catecholamines.