口腔科药物间及与膳食补剂间的相互作用

口腔科常用的一些药物可能和患者正在使用的药物以及膳食补剂等发生相互作用而产生不良后果,下表摘自第二版的The ADA Practical Guide to Patients with Medical Conditions.

  1. 口腔科药物可能和患者正在使用的药物发生相互作用
患者正在使用的药物 口腔科开具的药物 相互作用后果
抗微生物药·Antimicrobial Drugs
酒精·Alcohol 甲硝唑·Metronidazole Disulfuram‐like reaction of nausea, vomiting, headache, flushing
抗酸药和铁剂·Antacids and iron supplements 四环素类·Tetracyclines Loss of antibacterial action of tetracyclines
阿托伐他汀,辛伐他汀,普伐他汀·Atorvastatin, simvastatin, pravastatin 红霉素,克拉霉素·Erythromycin, clarithromycin Increased statin level precipitating possible muscle weakness and breakdown
卡马西平·Carbamazepine 红霉素,克拉霉素,多西环素,伊曲康唑,酮康唑·Erythromycin, clarithromycin, doxycycline, itraconazole, ketoconazole Increased risk of carbamazepine toxicity
环孢菌素·Cyclosporin 氟康唑,伊曲康唑,酮康唑,两性霉素,克拉霉素·Fluconazole, itraconazole, ketoconazole, amphotericin, clarithromycin Increased risk of nephrotoxicity
地高辛·Digoxin 红霉素,四环素类,伊曲康唑,克拉霉素·Erythromycin, tetracyclines, itraconazole, clarithromycin Digoxin toxicity
锂剂·Lithium 甲硝唑,四环素·Metronidazole, tetracycline Increased lithium toxicity
甲胺喋呤·Methotrexate 青霉素类·Penicillins Methotrexate toxicity
咪达唑仑和其他苯二氮卓类·Midazolam and other benzodiazepines 红霉素,克拉霉素,酮康唑,伊曲康唑·Erythromycin, Clarithromycin, ketoconazole, Itraconazole Profound sedation
口服避孕药·Oral contraceptives 阿莫西林,红霉素,四环素类,甲硝唑,氨苄西林,(可能还有其他一些抗生素)Amoxicillin, erythromycin, tetracyclines, metronidazole, ampicillin, possibly other antibiotics Contraceptive failure (low risk). (Patient should discuss with physician additional nonhormonal contraception use during antibiotic use and subsequent week
苯妥英钠·Phenytoin 氟康唑,酮康唑,甲硝唑·Fluconazole, ketoconazole, metronidazole Increased plasma levels of phenytoin
氨茶碱·Theophylline 红霉素,克拉霉素,酮康唑,伊曲康唑·Erythromycin, clarithromycin, ketoconazole, itraconazole Theophylline toxicity
华法林·Warfarin 红霉素,甲硝唑,四环素类,酮康唑,克拉霉素,头孢菌素类·Erythromycin, metronidazole, tetracyclines, ketaconazole, clarithromycin, cephalosporins Enhanced anticoagulation effect
抗炎药/Anti‐inflammatory Drugs
酒精·Alcohol 阿司匹林·Aspirin Increased risk of damage to gastric mucosa
卡托普利和其他ACEi制剂·Captopril, other ACE inhibitors 阿司匹林,布洛芬·Aspirin, ibuprofen Reduction in antihypertensive effect
皮质类固醇·Corticosteroids 阿司匹林·Aspirin Risk of salicylate toxicity on steroid withdrawal; increased risk of damage to gastric mucosa
环孢菌素·Cyclosporin 阿司匹林,非甾体类抗炎药·Aspirin, NSAIDs Increased risk of nephrotoxicity
地高辛·Digoxin 阿司匹林,布洛芬·Aspirin, ibuprofen Digoxin toxicity
肝素,华法林·Heparin, warfarin 阿司匹林,非甾体类抗炎药·Aspirin, NSAIDs Risk of hemorrhage
胰岛素,氯磺丙脲和其他降糖药·Insulin, chlorpropamide, other hypoglycemics 阿司匹林·Aspirin Risk of hypoglycemia
锂剂·Lithium 布洛芬,萘普生,塞来昔布·Ibuprofen, naproxen, celecoxib Lithium toxicity
甲胺喋呤·Methotrexate 阿司匹林,布洛芬,萘普生·Aspirin, ibuprofen, naproxen Methotrexate toxicity
苯妥英钠·Phenytoin 阿司匹林,非甾体类抗炎药·Aspirin, NSAIDs Increased plasma levels of phenytoin
丙戊酸(抗癫痫药)·Valproic acid 阿司匹林·Aspirin Risk of hemorrhage; increased valproate toxicity
其他药物·Other Drugs
酒精,镇静性H1受体拮抗肌,抗精神病药物,抗癫痫药·Alcohol, sedative H1 antagonists, neuroleptics, antiepileptics 地西泮·Diazepam Excessive sedation; impaired psychomotor skills; possible respiratory depression
左旋甲状腺素·Levothyroxine 肾上腺素·Epinephrine Coronary insufficiency in patients with coronary artery disease
普萘洛尔和其他beta受体阻滞剂·Propranolol, other beta blockers 肾上腺素·Epinephrine Marked hypertension and reflex bradycardia
三环抗忧郁剂·Tricyclic antidepressants 肾上腺素·Epinephrine Hypertensive reaction and possible cardiac arrhythmias
  1. 口腔科药物可能和患者正在使用的膳食补剂发生相互作用
膳食补剂-口腔科药物·Dietary Supplement–Dental Drug 潜在相互作用能力·Potential Interaction 影响·Implication
钙剂·Calcium
+多西环素··Doxycycline Moderate Reduced anti‐infective effectiveness
+四环素·Tetracycline Moderate Reduced anti‐infective effectiveness
夜来香(月见草油)Evening Primrose (Oenothera biennis)
+阿司匹林·Aspirin Moderate Enhanced bleeding
+布洛芬·Ibuprofen Moderate Enhanced bleeding
银杏叶提取液·Ginko biloba extract
+阿司匹林·Aspirin Major Enhanced bleeding
+布洛芬·Ibuprofen Major Enhanced bleeding
金丝桃·St. John’s wort (H. perforatum)
+阿奇霉素·Azithromycin Major Possible photosensitivity reactions
+苯二氮卓类·Benzodiazepines Major Reduced benzodiazepine effectiveness
+克拉霉素·Clarithromycin Major Reduced anti‐infective effectiveness
+克林霉素·Clindamycin Major Reduced anti‐infective effectiveness
+可待因·Codeine Major Increase narcotic‐induced sleep time and analgesia
+地塞米松·Dexamethasone Major Reduce dexamethasone effectiveness
+苯海拉明·Diphenhydramine Major Possible photosensitivity reactions
+多西环素·Doxycycline Major Reduced anti‐infective effectiveness and Possible photosensitivity reactions
+红霉素·Erythromycin Major Reduced anti‐infective effectiveness
+氢考酮·Hydrocodone Major Increase narcotic‐induced sleep time and analgesia
+布洛芬·Ibuprofen Major Possible photosensitivity reactions
+羟考酮·Oxycodone Major Increase narcotic‐induced sleep time and analgesia
+泼尼松·Prednisone Major Reduced prednisone effectiveness
+四环素·Tetracycline Major Reduced anti‐infective effectiveness
+扎莱普隆(新一代非苯二氮苣类镇静催眠药)Zaleplon Major Reduced zaleplon effectiveness
+唑吡坦·Zolpidem Major Reduced zaleplon effectiveness
缬草根(从缬草根提取的镇定药)Valerian
+苯二氮卓类·Benzodiazepines Major Excess sedation
+可待因·Codeine Major Excess sedation
+苯海拉明·Diphenhydramine Major Excess sedation
+氢考酮·Hydrocodone Major Excess sedation
+羟考酮·Oxycodone Major Excess sedation
+扎莱普隆·Zaleplon Major Excess sedation
+唑吡坦·Zolpidem Major Excess sedation

Major: high severity and probable occurrence;
Moderate: moderate severity and probable occurrence or high severity and possible occurrence.

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