Concomitant use of roxithromycin with ergotamine and its derivatives is contraindicated, since may reduce perfusion limb tissue, which may lead to necrosis. Not recommended combinations When using roxithromycin with drugs metabolized by using isoenzyme sustanon 250 gains, such as astemizole, cisapride or pimozide, increased plasma concentration of the latter and increase the risk of lengthening the interval and / or development arrhythmia (for “pirouette” type). Despite the fact that the weakly inhibits roxithromycin isoenzyme , it is impossible to exclude the influence of the metabolism of these drugs.Therefore, in order to avoid fatal side effects is not recommended the simultaneous use of roxithromycin and astemizole, cisapride or pimozide. Some macrolides pharmacokinetic interaction with terfenadine,resulting in an increase in the plasma concentration of the latter, which could result in the development of ventricular arrhythmias (usually “pirouette” type) .
Despite the fact that such a response has not been demonstrated in the application roxithromycin and studies with a small number of healthy volunteers revealed no pharmacokinetic interaction roxithromycin and terfenadine or relevant changes in the electrocardiogram , the simultaneous use of drugs is not recommended. Combinations of drugs in which application should caution with simultaneous use of roxithromycin with drugs that prolong the interval (eg, antiarrhythmic drugs IA (eg., procainamide) and III classes (eg, amiodarone), tricyclic antidepressants, methadone, macrolides, certain antifungals (fluconazole), fluoroquinolones (moxifloxacin ), antipsychotics (neuroleptics) (eg, clozapine, risperidone), certain antiviral drugs (telaprevir, citalopram) may cause severe arrhythmias, in particular for “pirouette” type, so be careful. no clinically significant interaction of roxithromycin with warfarin is not revealed . It has been reported to increase the prothrombin time and international normalized ratio (INR), while the use of vitamin K antagonists, so in the period of treatment is necessary to monitor the INR.
A study in vitro showed that the roxithromycin may displace sustanon 250 gains disopyramide of connection to plasma proteins resulting in blood serum increase . Therefore, while the use of roxithromycin and disopyramide is recommended to monitor the ECG and, if possible, the plasma concentration of the latter. Research has shown that roxithromycin may increase the absorption of digoxin. This effect is common to all macrolides, may very rarely result in cardiac glycoside intoxication. This may manifest symptoms such as nausea, vomiting, diarrhea, headache and dizziness, heart rhythm disturbance. Therefore, while the use of roxithromycin and digoxin (or other cardiac glycoside) necessary to monitor ECG and plasma concentrations of digoxin.
The simultaneous use of roxithromycin with inhibitors hydroxymethylglutaryl-CoA reductase inhibitors (statins) increase the risk of rhabdomyolysis due to increased plasma concentrations of statins, so you should apply this combination of drugs under the close supervision of a physician. Roxithromycin increases the sustanon 250 gains (area under the curve “concentration-time”) midazolam by an average of 47%, which reinforces and increases the midazolam action. Roxithromycin slightly increases the plasma concentration of theophylline, which does not require dose adjustment. Roxithromycin may increase the AUCbromocriptine, which can lead to an increased risk of side effects. Roxithromycin increases plasma concentration of ciclosporin by 50%. Roxithromycin may increase the plasma concentration of rifabutin. in women with concurrent therapy with hormonal contraceptives containing estrogen and progesterone, increases the risk of side effects. There were no clinically significant interaction roxithromycin with carbamazepine, ranitidine, aluminum hydroxide and magnesium. while the use of colchicine was observed increase of plasma concentrations of colchicine, which can lead to increased risk of its side effects, including nephrotoxicity. while the use of agonists of dopamine receptors (in including bromocriptine, pergolide, lisuride, cabergoline) there was an increase of plasma concentrations of the latter, which may enhance the pharmacodynamic effects and increase the risk of their side effects. At simultaneous application with cyclosporine was an increase in plasma concentrations of cyclosporine by 50%, which is gradually decreased after discontinuation of roxithromycin. Acheter steroide anabolisant musculation, steroide anabolisant achat danger des steroides anabolisants.