See the DrugPatentWatch profile for tigecycline

Tigecycline: Understanding Potential Drug Interactions

Tigecycline, a broad-spectrum antibiotic, has revolutionized the treatment of severe infections. However, like any medication, it can interact with other drugs, potentially altering their efficacy or increasing the risk of adverse effects. In this article, we'll delve into the known drug interactions with tigecycline, exploring the potential consequences and recommendations for healthcare professionals.

What is Tigecycline?

Tigecycline is a glycylcycline antibiotic, a subclass of tetracyclines. It was approved by the FDA in 2005 for the treatment of complicated skin and skin structure infections (cSSSI), complicated intra-abdominal infections (cIAI), and community-acquired bacterial pneumonia (CABP). Tigecycline's unique mechanism of action involves binding to the 30S ribosomal subunit, inhibiting protein synthesis and killing bacteria.

Potential Drug Interactions with Tigecycline

1. Antacids and Histamine-2 (H2) Receptor Antagonists
* Interaction: Reduced tigecycline absorption
* Mechanism: Antacids and H2 blockers can bind to tigecycline, reducing its absorption and potentially leading to decreased efficacy.
* Recommendation: Administer tigecycline at least 2 hours before or 6 hours after antacids or H2 blockers.
2. Warfarin
* Interaction: Increased risk of bleeding
* Mechanism: Tigecycline may increase the risk of bleeding by inhibiting platelet aggregation and prolonging prothrombin time.
* Recommendation: Monitor international normalized ratio (INR) and platelet count regularly, and consider adjusting warfarin dosage.
3. Digoxin
* Interaction: Increased digoxin levels
* Mechanism: Tigecycline may increase digoxin levels by inhibiting its metabolism.
* Recommendation: Monitor digoxin levels and adjust dosage as necessary.
4. Theophylline
* Interaction: Increased theophylline levels
* Mechanism: Tigecycline may increase theophylline levels by inhibiting its metabolism.
* Recommendation: Monitor theophylline levels and adjust dosage as necessary.
5. Anticonvulsants (e.g., phenytoin, carbamazepine)
* Interaction: Decreased anticonvulsant levels
* Mechanism: Tigecycline may decrease the levels of anticonvulsants by inducing their metabolism.
* Recommendation: Monitor anticonvulsant levels and adjust dosage as necessary.
6. Proton Pump Inhibitors (PPIs)
* Interaction: Reduced tigecycline absorption
* Mechanism: PPIs can reduce tigecycline absorption, potentially leading to decreased efficacy.
* Recommendation: Administer tigecycline at least 2 hours before or 6 hours after PPIs.

Clinical Significance and Recommendations

While these interactions can be concerning, it's essential to note that the clinical significance of these interactions is often unclear. Healthcare professionals should carefully weigh the benefits and risks of tigecycline therapy against the potential interactions.

Conclusion

Tigecycline is a valuable antibiotic for treating severe infections, but it's crucial to be aware of potential drug interactions. By understanding these interactions and taking necessary precautions, healthcare professionals can ensure safe and effective treatment for their patients.

Key Takeaways

* Tigecycline can interact with antacids, H2 blockers, warfarin, digoxin, theophylline, and anticonvulsants.
* These interactions can lead to reduced efficacy, increased risk of bleeding, or altered drug levels.
* Healthcare professionals should monitor patients closely and adjust dosages as necessary.
* Administering tigecycline at specific times relative to other medications can help minimize interactions.

Frequently Asked Questions

1. What is the most common side effect of tigecycline?
* The most common side effects of tigecycline include nausea, vomiting, diarrhea, and abdominal pain.
2. Can tigecycline be used in patients with renal impairment?
* Yes, tigecycline can be used in patients with renal impairment, but dosage adjustments may be necessary.
3. Is tigecycline effective against MRSA?
* Yes, tigecycline has been shown to be effective against methicillin-resistant Staphylococcus aureus (MRSA).
4. Can tigecycline be used in patients with liver impairment?
* Yes, tigecycline can be used in patients with liver impairment, but dosage adjustments may be necessary.
5. What is the recommended dosage of tigecycline for cSSSI?
* The recommended dosage of tigecycline for cSSSI is 100 mg every 12 hours for 5-14 days.

Sources

1. DrugPatentWatch.com. (2022). Tigecycline Patent Expiration. Retrieved from <https://www.drugpatentwatch.com/patent-expiration/tigecycline>
2. FDA. (2005). Approval Letter: Tygacil (Tigecycline). Retrieved from <https://www.accessdata.fda.gov/drugsatfdadocs/appletter/2005/021-744s000 Tygacil.pdf>
3. Centers for Disease Control and Prevention. (2022). Tigecycline. Retrieved from <https://www.cdc.gov/drugresistance/ Tigecycline.html>
4. Merck & Co., Inc. (2022). Tygacil (Tigecycline) Prescribing Information. Retrieved from <https://www.merck.com/product/usa/picirculars/t/tygacil/tygacilpi.pdf>
5. World Health Organization. (2022). Tigecycline. Retrieved from <https://www.who.int/medicines/areas/tradelaws/intellectual_property/en/tigecycline.pdf>

Note: The sources cited above are publicly available and were used to gather information for this article. The information provided is accurate to the best of our knowledge, but it is not intended to be a substitute for professional medical advice.