Famotidine with Cefpodoxime Proxetil Interaction Details

Brand Names Associated with Famotidine

Medical Content Editor Dr. Brian Staiger, PharmD
Last updated Nov 13, 2023

Interaction Effect

Decreased cefpodoxime effectiveness

Interaction Summary

Drugs that raise gastric pH, such as H2 blockers, reduce cefpodoxime absorption.

Severity

Moderate

Onset

Rapid

Evidence

Probable

How To Manage Interaction

Alternative antibiotic therapy (e.g., select another third generation cephalosporin or a second generation cephalosporin with similar activity) should be considered. If possible, switch to another anti-ulcer medication (e.g., sucralfate) and take cefpodoxime at least two hours before the dose. Because staggered administration may not be completely reliable, aggressively monitor these patients for continued antibiotic efficacy.

Mechanism Of Interaction

Decreased cefpodoxime absorption

Literature Reports

A) Administration of ranitidine interferes with the oral absorption of cefpodoxime proxetil. One study showed that gastric pH was inversely related to peak plasma cefpodoxime concentrations and AUCs. Administration of cefpodoxime with ranitidine 150 mg twice a day significantly reduced the peak plasma concentration and AUC of cefpodoxime . The clinical significance of this interaction is unknown.

B) Drugs that raise gastric pH reduce cefpodoxime absorption. A single dose of famotidine 40 mg given one hour before cefpodoxime was shown to decrease cefpodoxime AUC by 40% .

C) Concomitant administration of cefpodoxime and H2 blockers reduces peak plasma levels of cefpodoxime by 24% to 42% and the extent of absorption by 27% to 32%, respectively. The rate of absorption is not altered by these concomitant medications .

Famotidine Overview

• Prescription famotidine is used to treat ulcers (sores on the lining of the stomach or small intestine); gastroesophageal reflux disease (GERD, a condition in which backward flow of acid from the stomach causes heartburn and injury of the esophagus [tube that connects the mouth and stomach]); and conditions where the stomach produces too much acid, such as Zollinger-Ellison syndrome (tumors in the pancreas or small intestine that cause increased production of stomach acid). Over-the-counter famotidine is used to prevent and treat heartburn due to acid indigestion and sour stomach caused by eating or drinking certain foods or drinks. Famotidine is in a class of medications called H₂ blockers. It works by decreasing the amount of acid made in the stomach.

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.

Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.

Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.

Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.

Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.

Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.

How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.

Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.

Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

• Gold Standard Drug Database
• Micromedex
• Lexicomp
• DrugBank

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.