Trimic Drug Interactions

Due to metronidazole absorption, the following interactions can be seen if used concomitantly with the drugs below: Alcohol: Alcohol intolerance (disulfiram-like reaction).
Amiodarone: Increase in risk of cardiotoxicity (QT prolongation, Torsades de pointes, cardiac arrest).
Astemizole and terfenadine: Metronidazole inhibits the metabolism of these drugs and increases their plasma concentrations.
Disulfiram: Central nervous system related effects (eg, psychotic reactions).
Phenytoin: Increase in blood levels of phenytoin, decreases in blood levels of metronidazole.
Phenobarbital: Decrease in blood levels of metronidazole.
Fluorouracil: Increase in blood levels and toxicity of fluorouracil.
Carbamazepine: Increase in blood concentration of carbamazepine.
Lithium: Increase in blood levels and lithium toxicity.
Oral anticoagulants: Increase in anticoagulant effect.
Cyclosporine: Increase in cyclosporine toxicity risk.
Cimetidine: Increase in blood levels of metronidazole and the risk of neurologic side effects.
Interference with blood levels of liver enzymes, glucose (hexokinase method), theophylline and procainamide have been observed during the treatment with metronidazole.
Due to miconazole nitrate absorption, the following interactions can be seen if used concomitantly with the drugs below: Acenocoumarol, Anisindione, Dicumarol, Phenindione, Phenprocoumon, Warfarin: Increase in bleeding risk.
Astemizole, cisapride and terfenadine: Miconazole inhibits the metabolism of these drugs and increase their plasma concentrations.
Fentanyl: Increase or prolonged effects of opioid (CNS depression, respiratory depression).
Glimepiride: Increase of hypoglycemic action.
Carbamazepine: Decrease in carbamazepine metabolism.
Oxybutinin: Increase in oxycodone plasma concentration or exposure to oxybutinin.
Oxycodone: Increase in oxycodone plasma concentration and reduction in clearance.
Pimozide: Increase in cardiotoxicity risk (QT prolongation, Torsades de pointes, cardiac arrest).
Cyclosporine: Increase in cyclosporine risk toxicity (renal dysfunction, cholestasis, parasthesias).
Tolterodine: Increase in tolterodine bioavailability in individuals with deficient cytochrome P450 2DC activity.
Trimetrexate: Increase in trimetrexate toxicity (bone marrow suppression, renal and hepatic dysfunction and gastrointestinal ulceration).
Do not use barrier contraceptives like condoms with the use of Vaginal Suppositories since it may lead to breaking of rubber.