Macrolides and Drug-Drug Interactions - Pharmacology

Macrolides have various effects on other medications. Therefore, the nursing assessment should include obtaining a history of all drugs (OTC or prescribed) or herbals the patient may be taking. Macrolides can increase the therapeutic levels of alfentanil (Alfenta), carbamezepine (Tegretol), and cyclosporine (Sandimmune), resulting in the patient experiencing a toxic effect.

Terfenadine (Seldane) or astemizole (Hismanal) given with macrolides might cause toxicity to the heart. The patient is also at risk for hemorrhage if the patient takes both warfarin (Coumadin) and marolides within the same time period. The patient may also experience increased theophylline levels which can lead to toxicity when theophylline is given along with zanthines such as aminophylline and caffeine.


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