Neomycin-Polymyxin

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Drug Information

Summary of Interactions with Vitamins, Herbs, & Foods

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

Reduce Side Effects

  • Probiotics

    A common side effect of antibiotics is diarrhea, which may be caused by the elimination of beneficial bacteria normally found in the colon. Controlled studies have shown that taking probiotic microorganisms—such as Lactobacillus casei, Lactobacillus acidophilus, Bifidobacterium longum, or Saccharomyces boulardii—helps prevent antibiotic-induced diarrhea.81

    The diarrhea experienced by some people who take antibiotics also might be due to an overgrowth of the bacterium Clostridium difficile, which causes a disease known as pseudomembranous colitis. Controlled studies have shown that supplementation with harmless yeast—such as Saccharomyces boulardii or Saccharomyces cerevisiae (baker’s or brewer’s yeast)—helps prevent recurrence of this infection.82 , 83

    Treatment with antibiotics also commonly leads to an overgrowth of yeast (Candida albicans) in the vagina (candida vaginitis) and the intestines (sometimes referred to as “dysbiosis”). Controlled studies have shown that Lactobacillus acidophilus might prevent candida vaginitis.84

  • Vitamin C

    Tooth discoloration is a side effect of minocycline observed primarily in young children, but it may occur in adults as well. Vitamin C supplementation may prevent staining in adults taking minocycline.97

  • Brewer’s Yeast

    A common side effect of antibiotics is diarrhea, which may be caused by the elimination of beneficial bacteria normally found in the colon. Controlled studies have shown that taking probiotic microorganisms—such as Lactobacillus casei, Lactobacillus acidophilus, Bifidobacterium longum, or Saccharomyces boulardii—helps prevent antibiotic-induced diarrhea.99

    The diarrhea experienced by some people who take antibiotics also might be due to an overgrowth of the bacterium Clostridium difficile, which causes a disease known as pseudomembranous colitis. Controlled studies have shown that supplementation with harmless yeast—such as Saccharomyces boulardii 100 or Saccharomyces cerevisiae (baker’s or brewer’s yeast)101—helps prevent recurrence of this infection. In one study, taking 500 mg of Saccharomyces boulardii twice daily enhanced the effectiveness of the antibiotic vancomycin in preventing recurrent clostridium infection.102 Therefore, people taking antibiotics who later develop diarrhea might benefit from supplementing with saccharomyces organisms.

    Treatment with antibiotics also commonly leads to an overgrowth of yeast (Candida albicans) in the vagina (candida vaginitis) and the intestines (sometimes referred to as “dysbiosis”). Controlled studies have shown that Lactobacillus acidophilus might prevent candida vaginitis.103

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Support Medicine

  • Bromelain

    When taken with amoxicillin, bromelain was shown to increase absorption of amoxicillin in humans.109 When 80 mg of bromelain was taken together with amoxicillin and tetracycline, blood levels of both drugs increased, though how bromelain acts on drug metabolism remains unknown.110 An older report found bromelain also increased the actions of other antibiotics, including penicillin, chloramphenicol, and erythromycin, in treating a variety of infections. In that trial, 22 out of 23 people who had previously not responded to these antibiotics did so after adding bromelain taken four times per day.111

    Doctors will sometimes prescribe enough bromelain to equal 2,400 gelatin dissolving units (listed as GDU on labels) per day. This amount would equal approximately 3,600 MCU (milk clotting units), another common measure of bromelain activity.

  • Probiotics
    In one study, taking 500 mg of Saccharomyces boulardii twice daily enhanced the effectiveness of the antibiotic vancomycin in preventing recurrent clostridium infection.115 Therefore, people taking antibiotics who later develop diarrhea might benefit from supplementing with saccharomyces organisms.

Reduces Effectiveness

  • Khat

    Khat (Catha edulis) is an herb found in East Africa and Yemen that has recently been imported into the United States. Studies have shown that chewing khat significantly reduces the absorption of ampicillin,119 which might reduce the effectiveness of the antibiotic. Therefore, people taking ampicillin should avoid herbal products that contain khat.

  • Magnesium

    Taking calcium, iron, magnesium, or zinc at the same time as minocycline can decrease the absorption of both the drug121 , 122 and the mineral. Therefore, calcium, iron, magnesium, or zinc supplements, if used, should be taken an hour before or after the drug.

  • Zinc

    Taking calcium, iron, magnesium, or zinc at the same time as minocycline can decrease the absorption of both the drug125 , 126 and the mineral. Therefore, calcium, iron, magnesium, or zinc supplements, if used, should be taken an hour before or after the drug.

Potential Negative Interaction

  • none

Explanation Required 

  • Barberry

    Berberine is a chemical extracted from goldenseal (Hydrastis canadensis), barberry (Berberis vulgaris), and Oregon grape (Berberis aquifolium), which has antibacterial activity. However, one double-blind study found that 100 mg berberine given with tetracycline (a drug closely related to doxycycline) reduced the efficacy of tetracycline in people with cholera.129 In that trial, berberine may have decreased tetracycline absorption. Another double-blind trial found that berberine neither improved nor interfered with tetracycline effectiveness in cholera patients.130 Therefore, it remains unclear whether a significant interaction between berberine-containing herbs and doxycycline and related drugs exists.

  • Vitamin K

    Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K.133 , 134 Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

References

1. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

2. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

3. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

4. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

5. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

6. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

7. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

8. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

9. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 256-8.

10. Freinberg N, Lite T. Adjunctive ascorbic acid administration in antibiotic therapy. J Dent Res 1957;36:260-2.

11. Yomoda M, Komai A, Hasimoto T. Sublamina densa-type linear IgA bullous dermatosis successfully treated with oral tetracycline and niacinamide. Br J Dermatol 1999;141:608-9.

12. Dragan L, Eng AM, Lam S, Persson T. Tetracycline and niacinamide: treatment alternatives in ocular cicatricial pemphigoid. Cutis 1999;63:181-3.

13. Berk MA, Lorincz AL. The treatment of bullous pemphigoid with tetracycline and niacinamide. A preliminary report. Arch Dermatol 1986;122:670-4.

14. Kawahara Y, Hashimoto T, Ohata K, Nishikawa T. Eleven cases of bullous pemphigoid treated with combination of minocycline and nicotinamide. Eur J Dermatol 1996;6:427-9.

15. Reiche L, Wojnarowska F, Mallon E. Combination therapy with nicotinamide and tetracyclines for cicatricial pemphigoid; further support for its efficacy. Clin Exp Dermatol 1998;23:254-7.

16. Peoples D, Fivenson DP. Linear IgA bullous dermatosis: successful treatment with tetracycline and nicotinamide. J Am Acad Dermatol 1992;26:498-9.

17. Chaffins ML, Collison D, Fivenson DP. Treatment of pemphigus and linear IgA dermatosis with nicotinamide and tetracycline: a review of 13 cases. J Am Acad Dermatol 1993;28:998-1000.

18. Shah SA, Ormerod AD. Dermatitis herpetiformis effectively treated with heparin, tetracycline and nicotinamide. Clin Exp Dermatol 2000;25:204-5.

19. Zemtsov A, Neldner KH. Successful treatment of dermatitis herpetiformis with tetracycline and nicotinamide in a patient unable to tolerate dapsone. J Am Acad Dermatol 1993;28:505-6.

20. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

21. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

22. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 256-8.

23. Freinberg N, Lite T. Adjunctive ascorbic acid administration in antibiotic therapy. J Dent Res 1957;36:260-2.

24. Yomoda M, Komai A, Hasimoto T. Sublamina densa-type linear IgA bullous dermatosis successfully treated with oral tetracycline and niacinamide. Br J Dermatol 1999;141:608-9.

25. Dragan L, Eng AM, Lam S, Persson T. Tetracycline and niacinamide: treatment alternatives in ocular cicatricial pemphigoid. Cutis 1999;63:181-3.

26. Berk MA, Lorincz AL. The treatment of bullous pemphigoid with tetracycline and niacinamide. A preliminary report. Arch Dermatol 1986;122:670-4.

27. Kawahara Y, Hashimoto T, Ohata K, Nishikawa T. Eleven cases of bullous pemphigoid treated with combination of minocycline and nicotinamide. Eur J Dermatol 1996;6:427-9.

28. Reiche L, Wojnarowska F, Mallon E. Combination therapy with nicotinamide and tetracyclines for cicatricial pemphigoid; further support for its efficacy. Clin Exp Dermatol 1998;23:254-7.

29. Peoples D, Fivenson DP. Linear IgA bullous dermatosis: successful treatment with tetracycline and nicotinamide. J Am Acad Dermatol 1992;26:498-9.

30. Chaffins ML, Collison D, Fivenson DP. Treatment of pemphigus and linear IgA dermatosis with nicotinamide and tetracycline: a review of 13 cases. J Am Acad Dermatol 1993;28:998-1000.

31. Shah SA, Ormerod AD. Dermatitis herpetiformis effectively treated with heparin, tetracycline and nicotinamide. Clin Exp Dermatol 2000;25:204-5.

32. Zemtsov A, Neldner KH. Successful treatment of dermatitis herpetiformis with tetracycline and nicotinamide in a patient unable to tolerate dapsone. J Am Acad Dermatol 1993;28:505-6.

33. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

34. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

35. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

36. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

37. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

38. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

39. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

40. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

41. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

42. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

43. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

44. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

45. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

46. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

47. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

48. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

49. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

50. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

51. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

52. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

53. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

54. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

55. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

56. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

57. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

58. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

59. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 256-8.

60. Freinberg N, Lite T. Adjunctive ascorbic acid administration in antibiotic therapy. J Dent Res 1957;36:260-2.

61. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 256-8.

62. Freinberg N, Lite T. Adjunctive ascorbic acid administration in antibiotic therapy. J Dent Res 1957;36:260-2.

63. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

64. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

65. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

66. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

67. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

68. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

69. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

70. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

71. Suzuki K, Fukushima T, Meguro K, et al. Intracranial hemorrhage in an infant owing to vitamin K deficiency despite prophylaxis. Childs Nerv Syst 1999;15:292-4.

72. Huilgol VR, Markus SL, Vakil NB. Antibiotic-induced iatrogenic hemobilia. Am J Gastroenterol 1997;92:706-7.

73. Bandrowsky T, Vorono AA, Borris TJ, Marcantoni HW. Amoxicllin-related postextraction bleeding in an anticoagulated patient with tranexamic acid rinses. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:610-2.

74. Kaiser CW, McAuliffe JD, Barth RJ, Lynch JA. Hypoprothrombinemia and hemorrhage in a surgical patient treated with cefotetan. Arch Surg 1991;126:524-5.

75. Conly J, Stein K. Reduction of vitamin K2 concentration in human liver associated with the use of broad spectrum antimicrobials. Clin Invest Med 1994;17:531-9.

76. Suzuki K, Fukushima T, Meguro K, et al. Intracranial hemorrhage in an infant owing to vitamin K deficiency despite prophylaxis. Childs Nerv Syst 1999;15:292-4.

77. Huilgol VR, Markus SL, Vakil NB. Antibiotic-induced iatrogenic hemobilia. Am J Gastroenterol 1997;92:706-7.

78. Bandrowsky T, Vorono AA, Borris TJ, Marcantoni HW. Amoxicllin-related postextraction bleeding in an anticoagulated patient with tranexamic acid rinses. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:610-2.

79. Kaiser CW, McAuliffe JD, Barth RJ, Lynch JA. Hypoprothrombinemia and hemorrhage in a surgical patient treated with cefotetan. Arch Surg 1991;126:524-5.

80. Conly J, Stein K. Reduction of vitamin K2 concentration in human liver associated with the use of broad spectrum antimicrobials. Clin Invest Med 1994;17:531-9.

81. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

82. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

83. Schellenberg D, Bonington A, Champion CM, et al. Treatment of Clostridium difficile diarrhoea with brewer's yeast. Lancet 1994;343:171-2.

84. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

85. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

86. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

87. Schellenberg D, Bonington A, Champion CM, et al. Treatment of Clostridium difficile diarrhoea with brewer's yeast. Lancet 1994;343:171-2.

88. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

89. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

90. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

91. Schellenberg D, Bonington A, Champion CM, et al. Treatment of Clostridium difficile diarrhoea with brewer's yeast. Lancet 1994;343:171-2.

92. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

93. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

94. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

95. Schellenberg D, Bonington A, Champion CM, et al. Treatment of Clostridium difficile diarrhoea with brewer's yeast. Lancet 1994;343:171-2.

96. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

97. Cheek CC, Heymann HO. Dental and oral discolorations associated with minocycline and other tetracycline analogs. J Esthet Dent 1999;11:43-8.

98. Cheek CC, Heymann HO. Dental and oral discolorations associated with minocycline and other tetracycline analogs. J Esthet Dent 1999;11:43-8.

99. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

100. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

101. Schellenberg D, Bonington A, Champion CM, et al. Treatment of Clostridium difficile diarrhoea with brewer's yeast. Lancet 1994;343:171-2.

102. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study. Gastroenterol 1989;96:981-8.

103. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

104. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

105. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

106. Schellenberg D, Bonington A, Champion CM, et al. Treatment of Clostridium difficile diarrhoea with brewer's yeast. Lancet 1994;343:171-2.

107. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study. Gastroenterol 1989;96:981-8.

108. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

109. Tinozzi S, Venegoni A. Effect of bromelain on serum and tissue levels of amoxicillin. Drugs Exp Clin Res 1978;4:39-44.

110. Luerti M, Vignali M. Influence of bromelain on penetration of antibiotics in uterus, salpinx and ovary. Drugs Exp Clin Res 1978;4:45-8.

111. Neubauer RA. A plant protease for potentiation of and possible replacement of antibiotics. Exp Med Surg 1961;19:143-60.

112. Tinozzi S, Venegoni A. Effect of bromelain on serum and tissue levels of amoxicillin. Drugs Exp Clin Res 1978;4:39-44.

113. Luerti M, Vignali M. Influence of bromelain on penetration of antibiotics in uterus, salpinx and ovary. Drugs Exp Clin Res 1978;4:45-8.

114. Neubauer RA. A plant protease for potentiation of and possible replacement of antibiotics. Exp Med Surg 1961;19:143-60.

115. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study. Gastroenterol 1989;96:981-8.

116. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study. Gastroenterol 1989;96:981-8.

117. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study. Gastroenterol 1989;96:981-8.

118. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study. Gastroenterol 1989;96:981-8.

119. Attel OA, Ali AA, Ali HM. Effect of khat chewing on the bioavailability of ampicillin and amoxicillin. J Antimicrob Chemother 1997;39:523-5.

120. Attel OA, Ali AA, Ali HM. Effect of khat chewing on the bioavailability of ampicillin and amoxicillin. J Antimicrob Chemother 1997;39:523-5.

121. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1535-7.

122. Brion M, Lambs L, Berthon G. Metal ion-tetracycline interactions in biological fluids. Part 5. Formation of zinc complexes with tetracycline and some of its derivatives and assessment of their biological significance. Agents Actions 1985;17:229-42.

123. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1535-7.

124. Brion M, Lambs L, Berthon G. Metal ion-tetracycline interactions in biological fluids. Part 5. Formation of zinc complexes with tetracycline and some of its derivatives and assessment of their biological significance. Agents Actions 1985;17:229-42.

125. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1535-7.

126. Brion M, Lambs L, Berthon G. Metal ion-tetracycline interactions in biological fluids. Part 5. Formation of zinc complexes with tetracycline and some of its derivatives and assessment of their biological significance. Agents Actions 1985;17:229-42.

127. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1535-7.

128. Brion M, Lambs L, Berthon G. Metal ion-tetracycline interactions in biological fluids. Part 5. Formation of zinc complexes with tetracycline and some of its derivatives and assessment of their biological significance. Agents Actions 1985;17:229-42.

129. Khin-Maung-U, Myo-Khin, Nyunt-Nyunt-Wai, et al. Clinical trial of berberine in acute watery diarrhoea. Br Med J 1985;291:1601-5.

130. Rabbani GH, Butler T, Knight J, et al. Randomized controlled trial of berberine sulfate therapy for diarrhea due to enterotoxigenic Escherichia coli and Vibrio cholerae. J Infect Dis 1987;155:979-84.

131. Khin-Maung-U, Myo-Khin, Nyunt-Nyunt-Wai, et al. Clinical trial of berberine in acute watery diarrhoea. Br Med J 1985;291:1601-5.

132. Rabbani GH, Butler T, Knight J, et al. Randomized controlled trial of berberine sulfate therapy for diarrhea due to enterotoxigenic Escherichia coli and Vibrio cholerae. J Infect Dis 1987;155:979-84.

133. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

134. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

135. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

136. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.