Management: Separate administration of antacids and oral tetracycline derivatives by several hours when possible to minimize the extent of this potential interaction
Bismuth Subcitrate:
May decrease the serum concentration of Tetracyclines
Management: Avoid administration of oral tetracyclines within 30 minutes of bismuth subcitrate administration
This is of questionable significance for at least some regimens intended to treat H. pylori infections.
Bismuth Subsalicylate:
May decrease the serum concentration of Tetracyclines
Management: Consider dosing tetracyclines 2 hours before or 6 hours after bismuth
The need to separate doses during Helicobacter pylori eradication regimens is questionable.
Divalent and Polyvalent Cations (Calcium, Magnesium, Zinc, Iron):
May decrease the absorption of tetracyclines
Of concern only with oral administration of both agents
Management: Consider administering the oral cation at least 2 hours before or 4 hours after the dose of tetracycline
CarBAMazepine:
May decrease the serum concentration of Doxycycline
Management: Consider increasing the doxycycline dose, or using another tetracycline derivative due to the potential for reduced doxycycline therapeutic effects when coadministered wth carbamazepine
Iron Preparations:
Tetracyclines may decrease the absorption of Iron Preparations
Iron Preparations may decrease the serum concentration of Tetracyclines
Management: Avoid this combination if possible. Administer oral iron preparations at least 2 hours before, or 4 hours after, the dose of the oral tetracycline derivative
Sucralfate:
May decrease the absorption of Tetracyclines
Management: Administer most tetracycline derivatives at least 2 hours prior to sucralfate in order to minimize the impact of this interaction
Antimicrobials
