Interaction between Methenamine and Lactobacillus acidophilus
Moderate Others

ID DDInter1169 and DDInter1017
Interaction INTERVAL: Coadministration of oral probiotic preparations with oral antibiotics may reduce the efficacy of the probiotic. It has been theorized that concomitant antibiotics may kill the live organisms found in lactobacillus-, bacillus coagulans-, and bifidobacteria-containing oral probiotic preparations. However, the clinical significance of the interaction has not been established.
Management Although data are limited, it may be prudent to advise patients to take oral probiotics at least 1 to 2 hours before or after an oral antibiotic.
References
Alternative for Methenamine J01X
Metronidazole (topical)
Oritavancin
Bacitracin
Spectinomycin
Daptomycin
Tinidazole
Polymyxin B
Dalbavancin
Telavancin
Alternative for Lactobacillus acidophilus -

Potential Metabolism Interactions

Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.