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I was given the antibiotic Cefuroxime tablets 500mg. I also

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I was given the antibiotic Cefuroxime tablets 500mg. I also take Omeprazole for stomach which is contraindicated. Can both of these drugs be taken the same day if taken at different times? Also are there any contraindications for use with Lisinopril, Toprol XL, Simvastatin, L Thyroxine or Gabapentin?
Wed, 7 Feb 2018 in Medicines and Side Effects
 
 
Answered by Dr. Bonnie Berger-Durnbaugh 33 minutes later
Brief Answer:
Information

Detailed Answer:
Hello and welcome,

The contraindication for taking cefuroxime while on omeprazole is because omeprazole decreases stomach acid which can significantly reduce the amount of cefuroxime in your system. So while it does not create a dangerous situation, the cefuroxime would not be as effective and possibly not effective.

In terms of timing, if you have been taking omeprazole for awhile, spacing them out by taking them at different times of the day won't help a lot.

So I recommend talking with the prescribing doctor to see if he/she still thinks it's worth taking the cefuroxime given that you are on omeprazole.

Regarding the other medications, I ran a search putting all of your meds plus cefuroxime in the data base search to be analyzed. The only thing that came up was that there is some risk of the omeprazole in combination with the statin (simvastatin) causing problems with the muscles.

I am including the information about cefuroxime and omeprazole below. It's from Lexicomp drug interaction database:
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Cefuroxime / Proton Pump Inhibitors

Route: This interaction only applies to orally administered cefuroxime axetil. This interaction does not apply when cefuroxime is administered via the intravenous or intramuscular routes.

Risk Rating X: Avoid combination

Summary Proton Pump Inhibitors may decrease the absorption of Cefuroxime. Severity Moderate Reliability Rating Fair

Patient Management Avoid concomitant use of oral cefuroxime axetil and proton pump inhibitors.

Proton Pump Inhibitors Interacting Members Dexlansoprazole, Esomeprazole, Lansoprazole, Omeprazole, Pantoprazole, RABEprazole

Discussion The concomitant use of cefuroxime and proton pump inhibitors has not been evaluated in a clinical study. However, in a clinical study of 6 healthy volunteers, the AUC of cefuroxime (given as a single dose of 1,000 mg cefuroxime axetil) was reduced by more than 60% when coadministered with a combination of ranitidine and sodium bicarbonate.1

In contrast, in a pharmacokinetic study of 7 dialysis patients, aluminum hydroxide (1,000 mg single dose) administered prior to cefuroxime axetil (1,000 mg single dose) had no effect on the maximum serum concentration or AUC of cefuroxime.2

The cefuroxime axetil prescribing information states that because drugs that reduce gastric acidity may reduce the bioavailability of cefuroxime, the concomitant use of cefuroxime axetil and proton pump inhibitors should be avoided.3

Footnotes

1. Sommers DK, van Wyk M, Moncrieff J, Schoeman HS. Influence of food and reduced gastric acidity on the bioavailability of bacampicillin and cefuroxime axetil. Br J Clin Pharmacol. 1984;18(4):535-539. [PubMed 0000]

2. Brink HS, Huisman RM, Geerlings W, de Jong PE. Phosphate binders do not reduce bioavailability of oral cefuroxime-axetil in patients on peritoneal dialysis treatment. Adv Perit Dial. 1994;10:179-182. [PubMed 0000]

3. Ceftin (cefuroxime axetil) [prescribing information]. Research Triangle Park, NC: GlaxoSmithKline; November 2016.

Above answer was peer-reviewed by
 
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