Interactions : אינטראקציות

4.5 Interactions with other medicinal products and other forms of interaction
Effects of other medicinal products
Acetylsalicylic acid, indomethacin and phenylbutazone decrease excretion of penicillins.

Allopurinol
The concurrent administration of allopurinol and ampicillin increases substantially the incidence of rashes in patients receiving both drugs as compared to patients receiving ampicillin alone. It is not known whether this potentiation of ampicillin rashes is due to allopurinol or the hyperuricemia present in these patients.

Oral hormonal contraceptives
Concurrent use of aminopenicillins and oral contraceptives has been connected with the possibility of decreased plasma level of oestrogens and progesterone and may reduce the efficacy of hormonal contraceptives.
Patients should be advised to use supplemental non-hormonal contraceptives measures.

Methotrexate
Concomitant administration with methotrexate may decreases the renal clearance of methotrexate and may lead to an increase of the toxicity of methotrexate. Serum methotrexate levels should be closely monitored.

Other antibiotics or chemotherapeutics
Aminopenicillins should not be used concomitantly with bacteriostatic antibiotics. There is a possibility that the antibacterial action of amoxicillin could be antagonised on co-administration with macrolides, tetracyclines, sulphonamides or chloramphenicol.

Aminoglycosides
AmpiSulVenir and aminoglycosides should not be reconstituted together due to the in vitro inactivation of aminoglycosides by the ampicillin component of AmpiSulVenir.
The mixing of aminoglycosides with ampicillin and sulbactam must be avoided in the solution for infusion.

Anticoagulants
With concurrent use of coumarin anticoagulants, such as warfarin, the effects of the anticoagulants may be increased. The changes in platelet aggregation and a prolongation of the prothrombin times has been observed.
Probenecid
Probenecid decreases the renal tubular secretion of ampicillin and sulbactam; therefore, its concurrent use of Probenecid with AmpiSulVenir may result in increased and prolonged blood levels of ampicillin and sulbactam.

Influence of laboratory tests
Administration of AmpiSulVenir will result in high urine concentration of ampicillin.
High urine concentrations of ampicillin may result in false positive reactions when testing for the presence of glucose in urine using Clinitest™, Benedict’s Solution or Fehling’s Solution.
It is recommended that glucose tests based on enzymatic glucose oxidase reactions (such as Clinistix™ or Testape™) be used.
Following administration of ampicillin to pregnant women, a transient decrease in plasma concentration of total conjugated estriol, estriol-glucuronide, conjugated estrone and estradiol has been noted. This effect may also occur with AmpiSulVenir.

Carcinogenesis, Mutagenesis, Impairment of Fertility: Long-term studies in animals have not been performed to evaluate carcinogenic or mutagenic potential.