Which antibiotics should be taken WITH OR JUST AFTER FOOD
(extra warning label)??
Which antibiotics should be taken ON AN EMPTY STOMACH i.e. 2 hours before or 2 hours after food
(extra warning label)
Penicillin (Penicillin V- Phenoxymethylpenicillin)
Which antibiotics should MILK be avoided 2 hours before or 2 hours after taking, as MILK DECREASES THEIR ABSORPTION?
As MILK contains CALCIUM- chelate to this forming a complex that cannot be absorbed
Which antibiotics SHOULD BE TAKEN WITH A FULL GLASS OF WATER (extra warning label)?
To avoid irritation of the oesophagus
Antacids contain calcium, magnesium and aluminium metal ions. Medicines containing IRON/ ZINC can also affect absorption. What antibiotics need to be taken 1 hour before or 2 hours after antacids/ iron or zinc products, and why?
NB: There is a cautionary label that incorporates both antacids and iron/zinc products: this is needed
Antibiotics can chelate with the metal ions and this will reduce the antibiotics absorption:
Tetracycline, oxytetracycline, doxycycline- remember these are contra-indicated in children under 12 years due to deposition in bones/ teeth (calcium binding- also avoided with milk)
Quinolones: Ciprofloxacin, levofloxacin, moxifloxacin
Nitrofurantoin- Magnesium only
What are the counselling points/ extra warning labels with Metronidazole?
Take WITH or just after FOOD
WITH A FULL GLASS OF WATER
Do NOT drink ALCOHOL
What are the counselling points/ extra warning labels with DOXYCYCLINE?
Do not take indigestion remedies (antacids)/ med's containing iron or zinc 2 hours before/ after
Drink with a full glass of water
Protect skin from sunlight- even on cloudy day
Space evenly throughout day
What extra warning label do
Do not take milk, indigestion remedies or med's contaning iron/ zinc 2 hours before or after
What are the extra warning labels for Isoniazid (used in TB)?
Take 30 to 60 mins before food
Do not stop taking unless doctor says (as its for TB- needed for long time!)
What are the extra warning labels for azithromycin?
DO not take indigestion remedies/ antacids at same time
Space doses evenly
NB: here the mention of zinc/iron products not needed
What are the extra warning labels for Nitrofurantoin?
May colour the urine (yellow/ brown)
Take with or just after food
Space doses evenly, don't stop taking unless told to