Neo-Penotran Forte Drug Interactions

Due to metronidazole absorption, the following interactions can be seen if used concomitantly with the drugs as follows: 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.
Carbamazepine: Increase in blood concentration of carbamazepine.
Cimetidine: Increase in blood levels of metronidazole and the risk of neurologic side effects.
Cyclosporine: Increase in cyclosporine toxicity risk.
Disulfiram: Central nervous system related effects (e.g. psychotic reactions).
Lithium: Increase in blood levels and lithium toxicity.
Phenytoin: Increase in blood levels of phenytoin, decrease in blood levels of metronidazole.
Phenobarbital: Decrease in blood levels of metronidazole.
Fluorouracil: Increase in blood levels and toxicity of fluorouracil.
Oral anticoagulants: Increase in anticoagulant effect.
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 as follows: Acenocoumarol, Anisindione, Dicumarol, Phenindione, Phenprocoumon, Warfarin: Increase in bleeding risk.
Astemizole, cisapride and terfenadine: Miconazole inhibits the metabolism of these drugs and increases their plasma concentrations.
Carbamazepine: Decrease in carbamazepine metabolism.
Cyclosporine: Increase in cyclosporine risk toxicity (renal dysfunction, cholestasis, paresthesias).
Fentanyl: Increase or prolonged effects of opioid (CNS depression, respiratory depression).
Phenytoin and Fosphenytoin: Increase in phenytoin toxicity risk (ataxy, hyperlexia, nystagmus, tremor).
Glimepiride: Increase of hypoglycemic action.
Oxybutynin: Increase in plasma concentration or exposure to oxybutynin.
Oxycodone: Increase in oxycodone plasma concentration and reduction in clearance.
Pimozide: Increase in cardiotoxicity risk (QT prolongation, torsades de pointes, cardiac arrest).
Tolterodine: Increase in tolterodine bioavalaibility in individuals with deficient cyctocrome P450 2D6 activity.
Trimetrexate: Increase in trimetrexate toxicity (bone marrow suppression, renal and hepatic dysfunction and gastrointestinal ulceration).
Additional information on special populations: No interaction study has been conducted on special populations.
Paediatric population: No interaction study has been conducted on children.