Omeprazole-Clarith-Amoxicillin

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Drug Information

Summary of Interactions with Vitamins, Herbs, & Foods

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • Calcium

    In a study of elderly women, administration of omeprazole decreased the absorption of calcium,1 presumably because the drug decreased the stomach's production of hydrochloric acid, which is necessary for calcium absorption. The form of calcium used in the study to test calcium absorption was calcium carbonate. Drugs that reduce stomach acid secretion may not inhibit other forms of calcium, such as calcium citrate.2

  • Folic Acid

    Tetracycline can interfere with the activity of folic acid, potassium, and vitamin B2, vitamin B6, vitamin B12, vitamin C, and vitamin K.5 This is generally not a problem when taking tetracycline for two weeks or less. People taking tetracycline for longer than two weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one study.6 The importance of this interaction is unknown.

    Taking large amounts of niacinamide, a form of vitamin B3, can suppress inflammation in the body. According to numerous preliminary reports, niacinamide, given in combination with tetracycline or minocycline, may be effective against bullous pemphigoid, a benign, autoimmune blistering disease of the skin.7 , 8 , 9 , 10 , 11 , 12 , 13 Preliminary evidence also suggests a similar beneficial interaction may exist between tetracycline and niacinamide in the treatment of dermatitis herpetiformis.14 , 15

  • Potassium

    Tetracycline can interfere with the activity of folic acid, potassium, and vitamin B2, vitamin B6, vitamin B12, vitamin C, and vitamin K.51 This is generally not a problem when taking tetracycline for two weeks or less. People taking tetracycline for longer than two weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one study.52 The importance of this interaction is unknown.

    Taking large amounts of niacinamide, a form of vitamin B3, can suppress inflammation in the body. According to numerous preliminary reports, niacinamide, given in combination with tetracycline or minocycline, may be effective against bullous pemphigoid, a benign, autoimmune blistering disease of the skin.53 , 54 , 55 , 56 , 57 , 58 , 59 Preliminary evidence also suggests a similar beneficial interaction may exist between tetracycline and niacinamide in the treatment of dermatitis herpetiformis.60 , 61

  • Vitamin B12

    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.95 , 96 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.

  • Vitamin B2

    Tetracycline can interfere with the activity of folic acid, potassium, and vitamin B2, vitamin B6, vitamin B12, vitamin C, and vitamin K.103 This is generally not a problem when taking tetracycline for two weeks or less. People taking tetracycline for longer than two weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one study.104 The importance of this interaction is unknown.

  • Vitamin C

    Treatment of healthy volunteers with omeprazole for four weeks resulted in a 12.3% decrease in blood levels of vitamin C.111

  • Vitamin K

    Several cases of excessive bleeding have been reported in people who take antibiotics.113 , 114 , 115 , 116 This side effect may be the result of reduced vitamin K activity and/or reduced vitamin K production by bacteria in the colon. One study showed that people who had taken broad-spectrum antibiotics had lower liver concentrations of vitamin K2 (menaquinone), though vitamin K1 (phylloquinone) levels remained normal.117 Several antibiotics appear to exert a strong effect on vitamin K activity, while others may not have any effect. Therefore, one should refer to a specific antibiotic for information on whether it interacts with vitamin K. Doctors of natural medicine sometimes recommend vitamin K supplementation to people taking antibiotics. Additional research is needed to determine whether the amount of vitamin K1 found in some multivitamins is sufficient to prevent antibiotic-induced bleeding. Moreover, most multivitamins do not contain vitamin K.

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. A nonpathogenic yeast known as Saccharomyces boulardii has been shown in two double-blind studies to decrease frequency of diarrhea in people taking amoxicillin as well as other penicillin-type drugs compared to placebo.151 , 152 There were overall few people in these studies using amoxicillin specifically, so there is no definitive proof that Saccharomyces boulardii will be beneficial for everyone when it is combined with amoxicillin. The studies used 1 gram of Saccharomyces boulardii per day.

    A separate double-blind study found that taking a combination of Lactobacillus acidophilus and Lactobacillus bulgaricus, two normal gut bacteria, with amoxicillin did not protect children from developing diarrhea.153 The authors of the study point out some problems such as the parents’ inability to consistently define diarrhea. However, at this time, it is unknown if lactobacillus products will reduce diarrhea due to amoxicillin.

    Controlled studies have shown that taking other probiotic microorganisms—such as Lactobacillus casei, Bifidobacterium longum, or Lactobacillus rhamnosus GG—also helps prevent antibiotic-induced diarrhea.154 , 155

    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 156 or Saccharomyces cerevisiae (baker’s or brewer’s yeast)157—helps prevent recurrence of this infection.

    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.158

  • 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.167

  • 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. A nonpathogenic yeast known as Saccharomyces boulardii has been shown in two double-blind studies to decrease frequency of diarrhea in people taking amoxicillin as well as other penicillin-type drugs compared to placebo.171 , 172 There were overall few people in these studies using amoxicillin specifically, so there is no definitive proof that Saccharomyces boulardii will be beneficial for everyone when it is combined with amoxicillin. The studies used 1 gram of Saccharomyces boulardii per day.

    A separate double-blind study found that taking a combination of Lactobacillus acidophilus and Lactobacillus bulgaricus, two normal gut bacteria, with amoxicillin did not protect children from developing diarrhea.173 The authors of the study point out some problems such as the parents’ inability to consistently define diarrhea. However, at this time, it is unknown if lactobacillus products will reduce diarrhea due to amoxicillin.

    Controlled studies have shown that taking other probiotic microorganisms—such as Lactobacillus casei or Bifidobacterium longum—also helps prevent antibiotic-induced diarrhea.174

    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 175 or Saccharomyces cerevisiae (baker’s or brewer’s yeast)176—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.177 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.178

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

    People taking omeprazole may increase absorption of dietary vitamin B12 by drinking cranberry (Vaccinium marocarpon) juice or other acidic liquids with vitamin B12-containing foods.197

    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.207 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.208 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.209

    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.219 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,223 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 drug227 , 228 and the mineral. Therefore, calcium, iron, magnesium, or zinc supplements, if used, should be taken an hour before or after the drug.

  • St. John’s Wort

    In a study of healthy human volunteers, supplementing with St. John's wort greatly decreased omeprazole blood levels by accelerating the metabolism of the drug.235 Use of St. John's wort may, therefore, interfere with the actions of omeprazole.

  • Zinc

    Taking calcium, iron, magnesium, or zinc at the same time as minocycline can decrease the absorption of both the drug237 , 238 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.245 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.246 Therefore, it remains unclear whether a significant interaction between berberine-containing herbs and doxycycline and related drugs exists.

  • Magnesium
    In a case report, a man developed severe magnesium deficiency after long-term treatment with a proton pump inhibitor (pantoprazole or lansoprazole).253 Severe magnesium deficiency as a result of the use of proton pump inhibitors appears to be rare among people who have no other risk factors for magnesium deficiency. However, in a study of hospitalized patients, the prevalence of low serum magnesium levels was significantly greater among users of proton pump inhibitors than among nonusers (23% vs. 11%).254 People taking proton pump inhibitors (PPIs) should ask their doctor whether to take a magnesium supplement or whether to have their magnesium levels monitored.255
    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Vitamin K

    Several cases of excessive bleeding have been reported in people who take antibiotics.259 , 260 , 261 , 262 This side effect may be the result of reduced vitamin K activity and/or reduced vitamin K production by bacteria in the colon. One study showed that people who had taken broad-spectrum antibiotics had lower liver concentrations of vitamin K2 (menaquinone), though vitamin K1 (phylloquinone) levels remained normal.263 Several antibiotics appear to exert a strong effect on vitamin K activity, while others may not have any effect. Therefore, one should refer to a specific antibiotic for information on whether it interacts with vitamin K. Doctors of natural medicine sometimes recommend vitamin K supplementation to people taking antibiotics. Additional research is needed to determine whether the amount of vitamin K1 found in some multivitamins is sufficient to prevent antibiotic-induced bleeding. Moreover, most multivitamins do not contain vitamin K.

    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. O'Connell MB, Madden DM, Murray AM, et al. Effects of proton pump inhibitors on calcium carbonate absorption in women: a randomized crossover trial. Am J Med 2005;118:778-81.

2. Recker RR. Calcium absorption and achlorhydria. N Engl J Med 1985;313:70-3.

3. O'Connell MB, Madden DM, Murray AM, et al. Effects of proton pump inhibitors on calcium carbonate absorption in women: a randomized crossover trial. Am J Med 2005;118:778-81.

4. Recker RR. Calcium absorption and achlorhydria. N Engl J Med 1985;313:70-3.

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

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

7. 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.

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

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

10. 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.

11. 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.

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

13. 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.

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

15. 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.

16. Russell RM, Golner BB, Krasinski SD, et al. Effect of antacid and H2 receptor antagonists on the intestinal absorption of folic acid. J Lab Clin Med 1988;112:458-63.

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

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

19. 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.

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

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

22. 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.

23. 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.

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

25. 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.

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

27. 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.

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

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

30. 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.

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

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

33. 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.

34. 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.

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

36. 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.

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

38. 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.

39. Russell RM, Golner BB, Krasinski SD, et al. Effect of antacid and H2 receptor antagonists on the intestinal absorption of folic acid. J Lab Clin Med 1988;112:458-63.

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

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

42. 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.

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

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

45. 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.

46. 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.

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

48. 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.

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

50. 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.

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

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

53. 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.

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

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

56. 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.

57. 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.

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

59. 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.

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

61. 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.

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

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

64. 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.

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

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

67. 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.

68. 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.

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

70. 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.

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

72. 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.

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

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

75. 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.

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

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

78. 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.

79. 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.

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

81. 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.

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

83. 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.

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

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

86. 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.

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

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

89. 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.

90. 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.

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

92. 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.

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

94. 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.

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

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

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

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

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

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

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

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

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

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

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

268. 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.

269. 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.

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

271. 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.

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

273. 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.

274. 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.

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

276. 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.

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

278. 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.