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Oral Retinoids and Vitamin A (above 10 000 IU/day): risk of intracranial hypertension.
Simultaneous administration of iron preparations and antacids, magnesium/aluminium and calcium hydroxides, oxides, salts and activated charcoal, cholestyramine, bismuth chelates and sucralfate may decrease cycline absorption. Medicinal products which increase gastric pH may reduce the absorption of tétracyclines. Enzyme inducers such as barbiturates, carbamazepine, phenytoin may accelerate the decomposition of tetracycline due to enzyme induction in the liver thereby decreasing its half-life. Consequently, a minimum 2-hour gap is necessary between the two treatments.
The effect of oral coumarin-type anticoagulants could be increased with an increased risk of haemorrhage.
Bacteriostatic medicinal products including Tetralysal may interfere with the bacteriocidal action of penicillin and beta-lactam antibiotics. Therefore, it is advisable that tetracycline-class drugs and penicillin should not be used in combination.
Laboratory tests interferences: Lymecycline could cause false-positive urine glucose determinations. It could also interfere with fluorometric determinations of urine catecholamines resulting in falsely increased values (Hingerty's method).
Tetracyclines and methoxyflurane, when used in combination, have been reported to result in fatal renal toxicity.
Didanosine: the digestive absorption of cyclines is decreased due to the increase in gastric pH (presence of an antacid in the didanosine tablet).
Some adverse effects have been reported with tetracycline therapy when used in combination with lithium; an interaction between lithium and the tetracycline class is a recognized interaction. Specifically, a combination of lymecycline with lithium may cause an increase in serum lithium levels.
