Drug General Information (ID: DDI4P3DBRK)
Drug Name			Sodium bicarbonate		Drug Info		Cefpodoxime		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antidiarrheals				Antibiotics
Structure

Mechanism of Sodium bicarbonate-Cefpodoxime Interaction (Severity Level: Moderate)
Altered gastric pH Click to Show/Hide Mechanism Graph
Drug Name		Sodium bicarbonate				Cefpodoxime
Mechanism		Gastric alkalinizer				Gastric pH sensitive
Key Mechanism Factor 1
		Factor Name		Gastric pH
		Factor Description		The normal pH range of gastric acid is between 1.5 and 3.5 and is highly acidic, consisting mainly of hydrochloric acid. Changes in the pH of the stomach can alter the absorption of drugs.
Mechanism Description		Decreased absorption of Cefpodoxime due to altered gastric pH caused by Sodium bicarbonate

Recommended Action
Management		Until further data are available, patients treated with cefpodoxime proxetil or cefuroxime axetil should avoid taking antacids or oral medications that contain antacids (e.g., didanosine buffered tablets or pediatric oral solution) for at least two hours before and after administration of the antibiotic.

References
1	Honig PK, Gillespie BK "Clinical significance of pharmacokinetic drug interactions with over-the-counter (OTC) drugs." Clin Pharmacokinet 35 (1998): 167-71. [PMID: 9784931]
2	Hughes GS, Heald DL, Barker KB, et al. "The effects of gastric pH and food on the pharmacokinetics of a new oral cephalosporin, cefpodoxime proxetil." Clin Pharmacol Ther 46 (1989): 674-85. [PMID: 2557183]
3	Saathoff N, Lode H, Neider K, et al "Pharmacokinetics of cefpodoxime and interactions with an antacid and an H2 receptor antagonist." Antimicrob Agents Chemother 36 (1992): 796-800. [PMID: 1354432]
4	Sommers DK, van Wyk M, Moncrieff J, Schoeman HS "Influence of food and reduced gastric acidity on the bioavailability of bacampicillin and cefuroxime axetil." Br J Clin Pharmacol 18 (1984): 535-9. [PMID: 6091711]