Analgesik/Pire dosis sediaan obat DOA OOA drug interaction

tik
Paracetamol IV Child: Onset: Oral: <1 hr. Duration: 4-6 hr May reduce serum levels w/ anticonvulsants
<10 kg: 7.5 mg/kg as a single dose, at least IV: 5-10 min (analgesia). IV: 6 (e.g. phenytoin, barbiturates,
4 hrly. Max: 30 mg/kg daily; 10-33 kg: 15 (analgesia); w/in 30 hr (antipyretic). carbamazepine). May enhance the
mg/kg as a single dose, at least 4 hrly. Max: min (antipyretic). anticoagulant effect of warfarin and other
60 mg/kg (up to 2 g) daily; coumarins w/ prolonged use. Accelerated
>33-50 kg: 15 mg/kg as a single dose, at absorption w/ metoclopramide and
least 4 hrly. Max: 60 mg/kg (up to 3 g) daily. domperidone. May increase serum levels w/
Admin by infusion over 15 min probenecid. May increase serum levels of
Oral Child: chloramphenicol. May reduce absorption w/
3 to <6 mth 60 mg; colestyramine w/in 1 hr of admin. May cause
6 mth to <2 yr 120 mg; severe hypothermia w/ phenothiazine
2 to <4 yr 180 mg;
4 to <6 yr 240 mg;
6 to <8 yr 240 or 250 mg;
8 to <10 yr 360 or 375 mg;
10 to <12 yr 480 or 500 mg;
12-16 yr 480 or 750 mg.
Given 4-6 hrly if necessary. Max: 4 doses in
24 hr.
Rectal Child:
3 mth to <1 yr 60-125 mg;
1 to <5 yr 125-250 mg;
5-12 yr 250-500 mg. Given 4-6 hrly if
necessary, up to 4 times daily.
Ibuprofen Oral Fever: 6 mth to 12 yr 10 mg/kg 6-8 hrly. Onset: Analgesic: Duration: 4-6 hr Increased risk of GI bleeding w/ warfarin,
Max: 40 mg/kg/day. 30-60 min. Anti- (oral). corticosteroids, SSRIs and aspirin. May
(harus dengan Intravenous inflammatory: 7 reduce the natriuretic effects of diuretics.
makanan) IV Closure of patent ductus arteriosus days (oral). Reduced antihypertensive effect of ACE
Child: Given as 3 IV doses infused over 15 inhibitors and angiotensin II receptor
min at 24-hr intervals. Initially 10 mg/kg antagonists. May increase toxicity of lithium
followed by 2 doses of 5 mg/kg. A 2nd and methotrexate. Increased nephrotoxicity
course may be given if ductus remains open w/ ciclosporin and tacrolimus.
after 48 hr. Dose should be based on birth
wt.

Antibiotic Dosis sediaan obat DOA OOA drug interaction

Ampicillin Intravenous May reduce the efficacy of OC. May alter
Meningitis Child: 150 mg/kg daily in divided INR while on warfarin and phenindione. May
doses. reduce the efficacy of oral typhoid vaccines.
Oral May reduce the excretion of methotrexate.
Biliary tract infections, Bronchitis, Reduced excretion w/ probenecid and
Endocarditis, Gastroenteritis, Listeriosis, sulfinpyrazone, resulting to increased risk of
Otitis media, Perinatal streptococcal toxicity. Allopurinol increases ampicillin-
infections, Peritonitis induced skin reactions. Reduced absorption
Child: <10 yr Half of adult routine dosage. w/ chloroquine. Bacteriostatic antibacterials
Parenteral (e.g. erythromycin, chloramphenicol,
Susceptible infections tetracycline) may interfere w/ the bactericidal
Child: <10 yr Half of adult routine dosage. action of ampicillin.

Amoxicillin Oral May reduce the efficacy of OC. May increase

Actinomycosis, Biliary tract infections, the effect of anticoagulants. Increased risk of
Bronchitis, Endocarditis, Gastroenteritis, allergic reactions w/ allopurinol. Increased
Gonorrhoea, Mouth infections, Otitis and prolonged blood levels w/ probenecid.
media, Pneumonia, Spleen disorders, Chloramphenicol, macrolides, sulfonamides
Typhoid and paratyphoid fever, Urinary and tetracyclines may interfere w/ the
tract infections bactericidal effect of amoxicillin.
Child: <40 kg: 40-90 mg/kg daily in 2-3
divided doses. Max: 3 g/day.
Oral
Prophylaxis of endocarditis
Child: 50 mg/kg as single dose, to be taken
1 hr before surgical procedure.
Parenteral
Susceptible infections
Child: <40 kg: 40-90 mg/kg daily in 2-3
divided doses. Max: 3 g/day.

Cefixime Child: >6 mth <50 kg: 8 mg/kg daily as a Increased prothrombin time (w/ or w/o
single or in 2 divided doses. bleeding) w/ anticoagulants (e.g. warfarin).
Increased plasma carbamazepine
concentrations w/ concomitant use.
Increased bioavailability w/ nifedipine.
Increased serum concentration w/
probenecid.
Ceftriaxone Child: 12 yr 20-50 mg/kg once daily May increase nephrotoxicity of
increased to 80 mg/kg in severe infections. aminoglycosides. May diminish therapeutic
Doses 50 mg/kg should be given as IV effect of BCG, typhoid vaccine, Na
infusion over at least 30 min. Max: 50 mg/kg picosulfate. May increase anticoagulant
 daily via IV infusion over 60 min (neonates). effect of vit K antagonists (e.g. warfarin). May
increase serum level w/ probenecid.
Potentially Fatal: Admin w/ Ca-containing IV
soln may cause precipitation of a crystalline
material in the lungs and kidneys.
Cefotaxime Parenteral Child: Increased risk of nephrotoxicity w/
0-1 wk 50 mg/kg/dose 12 hrly IV inj; >1-4 aminoglycosides. Increased serum
wk 50 mg/kg/dose 8 hrly IV inj; 1 mth to 12 concentration w/ probenecid.
yr <50 kg: 50-180 mg/kg IM or IV inj in 4-6
divided doses.
Parenteral May enhance the anticoagulant effect of vit K
Susceptible infections antagonists (e.g. warfarin). May diminish the
Cefazolin Child: >1 yr 25-50 mg/kg daily in 3 or 4 therapeutic effect of Na picosulfate, BCG and
divided doses to be given by deep IM inj, typhoid vaccine. May decrease the protein
slow IV inj over 3-5 min, or intermittent or binding of fosphenytoin and phenytoin.
continuous IV infusion. Max: 100 mg/kg daily Probenecid may decrease renal tubular
in divided doses for severe infections. secretion of cefazolin, resulting in increased
and prolonged blood levels. May increase
Parenteral the nephrotoxic effects of aminoglycosides.
Acute uncomplicated urinary tract
infections
Child: >1 yr 25-50 mg/kg daily in 3 or 4
divided doses to be given by deep IM inj,
slow IV inj over 3-5 min, or intermittent or
continuous IV infusion. Max: 100 mg/kg daily
in divided doses for severe infections.

Parenteral
Pneumonia
Child: >1 yr 25-50 mg/kg daily in 3 or 4
divided doses to be given by deep IM inj,
slow IV inj over 3-5 min, or intermittent or
continuous IV infusion. Max: 100 mg/kg daily
in divided doses for severe infections.

Parenteral May increase nephrotoxicity of

Pseudomonal lung infections in cystic aminoglycosides. May diminish therapeutic
Ceftazidime fibrosis effect of BCG, typhoid vaccine, Na
Child: <40 kg: 150 mg/kg daily in 3 divided picosulfate. May increase anticoagulant
doses. Max: 6 g daily. effect of vit K antagonists (e.g. warfarin). May
increase serum level w/ probenecid.

Parenteral
 Bone and joint infections, Complicated
intra-abdominal infections, Skin and skin
structure infections, complicated
Child: <40 kg: 100-150 mg/kg daily in 3
divided doses. Max: 6 g daily.

Parenteral
Bacterial meningitis, Empiric therapy for
febrile neutropenic patients, Nosocomial
pneumonia
Child: <40 kg: 150 mg/kg daily in 3 divided
doses. Max: 6 g daily.

Parenteral
Complicated urinary tract infections
Child: <40 kg: 100-150 mg/kg daily in 3
divided doses. Max: 6 g daily.

Oral Increases serum concentrations of digoxin,

Skin and soft tissue infections, ciclosporin, terfenadine, hexobarbital and
Azithromycin Respiratory tract infections phenytoin. Decreased rate of absorption w/
Child: >6 mth 10 mg/kg; 15-25 kg: 200 mg; antacids containing aluminium and
26-35 kg: 300 mg; 36-45 kg: 400 mg. All magnesium. Increased risk of ergot toxicity.
doses to be taken once daily for 3 days. Potentially Fatal: Increased risk of
cardiotoxicity w/ pimozide.

Oral
Prophylaxis of disseminated
Mycobacterium avium complex (MAC)
infections
Child: 20 mg/kg once wkly. Max: 1.2 g.
Alternatively 5 mg/kg once daily. Max: 250
mg.

Oral
Active immunisation against typhoid
fever caused by Salmonella typhi
Child: 3-17 yr 20 mg/kg (Max: 1 g) once
daily for 5-7 days or 10 mg/kg (Max: 500
mg).
 Intravenous Rhabdomyolysis w/ or w/o renal impairment
Susceptible infections w/ HMG-CoA reductase inhibitors (e.g.
Erythromycin Child: 12.5 mg/kg 4 times daily. Doses can simvastatin). Increased risk of colchicine
be doubled in severe infections. 0-1 mth 10- toxicity. Increased sedation w/
15 mg/kg tid. triazolobenzodiazepines and related
benzodiazepines (e.g. alprazolam,
midazolam). Theophylline may decrease and
cimetidine may increase erythromycin
Ophthalmic concentration. Hypotension, bradyarrhythmia
Treatment and prophylaxis of neonatal and lactic acidosis w/ Ca channel blockers
conjunctivitis (e.g. verapamil, amlodipine, diltiazem).
Child: As 0.5% oint: Apply approx 1 cm in Increased systemic exposure of sildenafil.
length into each of the lower conjunctival Increased or prolonged adverse effects w/
sac, then massage gently to spread the oint. ciclosporin, carbamazepine, tacrolimus,
alfentanil, disopyramide, rifabutin, quinidine,
Oral methylprednisolone, cilostazol, vinblastine
Prophylaxis of streptococcal infections in and bromocriptine. Increased risk of digoxin
patients with evidence of rheumatic fever toxicity. Increased bleeding w/ oral
or heart disease anticoagulants.
Child: For patients who are unable to take Potentially Fatal: QT prolongation, cardiac
penicillins or sulfonamides: 1 mth to 2 yr 125 arrhythmias, ventricular tachycardia,
mg bid. ventricular fibrillation, torsades de pointes w/
cisapride, pimozide, astemizole or
Oral terfenadine. Acute ergot toxicity w/
Respiratory tract infections, Skin and soft ergotamine and dihydroergotamine.
tissue infections, Susceptible infections
Child: 30-50 mg/kg daily, in 2-4 divided
doses, may be doubled in severe cases. <2
yr 500 mg daily in divided doses; 2-8 yr 1 g
daily in divided doses.

Oral Reduced efficacy w/ CYP3A inducers (e.g.

Susceptible infections, Respiratory tract phenytoin, carbamazepine). Strong inducers
Clarithromyci infections, Skin and soft tissue infections of CYP450 system (e.g. efavirenz, rifampicin)
n Child: 7.5 mg/kg bid for 5-10 days. may accelerate metabolism, thus lower
plasma levels of clarithromycin. Inhibition of
Oral metabolism w/ ritonavir. Torsades de pointes
Eradication of H. pylori associated with may result from concomitant quinidine or
peptic ulcer disease disopyramide. Increased phosphodiesterase
Child: 1 yr 7.5 mg/kg bid, may be given w/ inhibitor exposure w/ sildenafil, tadalafil or
another antibacterial and a PPI for 7 days. vardenafil. Increased risk of digoxin toxicity.
Decreased concentration of zidovudine.
 Concomitant use w/ atazanavir, itraconazole
or saquinavir may result to bi-directional drug
interactions. Hypotension, bradyarrhythmias,
and lactic acidosis may result when taken w/
verapamil. Increased risk of myopathy,
including rhabdomyolysis w/ HMG-CoA
reductase inhibitors. Increased risk of
hypoglycaemia w/ oral hypoglycaemic drugs
(e.g. pioglitazone) and insulin. Risk of
serious haemorrhage and elevation of INR
and prothrombin time w/ oral anticoagulants.
Increased ototoxicity w/ aminoglycosides.
Increased and prolonged sedation w/
triabenzodiazepines (e.g. midazolam).
Potentially Fatal: Concurrent use w/ ergot
alkaloids (e.g. ergotamine or
dihydroergotamine) is associated w/ acute
ergot toxicity characterised by vasospasm
and ischaemia of the extremities.
Concomitant use w/ astemizole, cisapride,
pimozide and terfenadine may result in QT
prolongation or ventricular cardiac
arrhythmia. Increases serum levels and
toxicity of colchicine.
Ophthalmic Additive effect w/ other neurotoxic and/or
Superficial ophthalmic infections nephrotoxic drugs including cephalosporins,
Gentamicine Adult: As 0.3% eye drops: Instill 1-2 drops methicillin, amphotericin B, ciclosporin,
into affected eye up to 6 times daily. For cisplatin, potent diuretics (e.g. ethacrynic
severe infections, initially, 1-2 drops every 15 acid, furosemide) and neuromuscular
min, reducing the frequency gradually as the blocking agents (e.g. succinylcholine,
infection is controlled. As 0.3% eye oint: tubocurarine). May potentiate the effect of
Place a small amount into the conjunctival anticoagulants (e.g. warfarin, phenindione).
sac 2-3 times daily. May antagonise the effect of neostigmine
Child: Same as adult dose. and pyridostigmine. Increased risk of
hypocalcaemia w/ bisphosphonates.
Otic/Aural Increased risk of neuromuscular blockade w/
Otitis externa botulinum toxin. Indometacin may increase
Adult: As 0.3% ear drops: Instill 2-3 drops in the plasma concentration of gentamicin in
the affected ear 3-4 times a day and at night. neonates.
Child: Same as adult dose.

Parenteral
Severe infections
 Child: 3-7.5 mg/kg daily in 3 divided doses.

Topical/Cutaneous
Skin infections
Child: Same as adult dose.

Clindamycine Oral May enhance the action of neuromuscular

Severe anaerobic infections blocking agents (e.g. atracurium). May
Child: 3-6 mg/kg 6 hrly. <10 kg: 37.5 mg 8 antagonise the effects of
hrly. parasympathomimetics. May competitively
inhibit the effects of macrolides, ketolides,
Parenteral streptogramins, linezolid and
Severe anaerobic infections chloramphenicol. Increased coagulation tests
Child: >1 mth 15-25 mg/kg daily in 3 or 4 (prothrombin time/INR) and/or bleeding w/ vit
divided doses; in severe infections, increase K antagonists (e.g. warfarin, acenocoumarol,
to 40 mg/kg daily and a min dose of 300 mg fluindione).
daily should be given regardless of body wt.

Per 480 mg
tab Co-
Cotrimoxazole trimoxazole:
Indo Farma Sulfamethoxaz
( sulfamethoxaz ole (SMZ) 400
ole and mg,
trimethoprim ; B trimethoprim
elongs to the (TM) 80
class of mg. Per 120
combinations of mg tab SMZ
sulfonamides 100 mg, TM
and 20 mg. Per 5
trimethoprim, mL susp SMZ
including 200 mg, TM
derivatives. 40 mg.
Used in the
systemic
treatment of
infections.)

Oral Decreased effects of iron and vitamin B12 in

Bacterial meningitis, Anaerobic bacterial anaemic patients. Phenobarbitone and
Chlorampheni infections, Anthrax, Brain abscess, rifampin reduce efficacy of chloramphenicol.
col Ehrlichiosis, Gas gangrene, Granuloma Impairs the action of oral contraceptives.
 inguinale, Infections caused by H. Potentially Fatal: Increases the effect of oral
influenzae, Listeriosis, Plague, anticoagulants, oral hypoglycaemic agents,
Psittacosis, Q fever, Severe phenytoin. Avoid concomitant administration
gastroenteritis, Severe melioidosis, with drugs that depress bone marrow
Severe systemic infections with function.
Camphylobacter fetus, Tularaemia,
Whipple's disease
Child: Premature and full-term neonates: 25
mg/kg/day in 4 divided doses. Full-term
infants >2 wk: 50 mg/kg/day in 4 divided
doses. Children: 50 mg/kg/day in 4 divided
doses increased to 100 mg/kg/day for
meningitis or severe infections.

Oral Potentially Fatal: Drugs that depress bone

Sexually transmitted diseases, marrow function.
Thiamphenico Susceptible infections
le Child: 30-100 mg/kg/day.

Intravenous Concurrent use w/ disulfiram may produce

Anaerobic bacterial infections psychotic reactions. May potentiate the effect
Metronidazol Child: 7.5 mg/kg 8 hrly. of oral anticoagulants. May increase risk of
e lithium toxicity. May reduce the renal
Oral clearance resulting to increased toxicity of 5-
Amoebiasis fluorouracil. May increase serum levels of
Child: 1-3 yr 100-200 mg tid; >3-7 yr 100- ciclosporin. May increase plasma levels of
200 mg 4 times daily; >7-10 yr 200-400 mg busulfan resulting to severe busulfan toxicity.
tid. Doses are given for 5-10 days. Enhanced metabolism w/ phenobarbital and
phenytoin resulting to decreased serum
Oral concentrations.
Prophylaxis of postoperative anaerobic
bacterial infections
Child: <40 wk 10 mg/kg as a single dose
before surgery; <12 yr 20-30 mg/kg as a
single dose 1-2 hr before surgery.

Oral
Giardiasis
Child: 1-3 yr 500 mg once daily; >3-7 yr 600-
800 mg once daily; >7-10 yr 1 g once daily.
Doses are given for 3 days.

Oral
Anaerobic bacterial infections
Child: <8 wk 7.5 mg/kg 12 hrly or 15 mg/kg
once daily. 8 wk to 12 yr 7.5 mg/kg 8 hrly or
20-30 mg/kg once daily. Duration of
treatment is usually for 7 days depending on
the severity of infection.

Oral
Trichomoniasis
Child: 1-10 yr 40 mg/kg as a single dose or
15-30 mg/kg daily in 2-3 divided doses for 7
days. Max: 2 g/dose.

Oral
Acute necrotising ulcerative gingivitis
Child: 1-3 yr 50 mg tid; >3-7 yr 100 mg
bid; >7-10 yr 100 mg tid. Doses are given for
3 days.

Rectal
Anaerobic infections
Child: <1 yr 125 mg; 1-5 yr 250 mg; >5-10
yr 500 mg. All doses to be given 8 hrly for 3
days, then 12 hrly thereafter until oral
medication is possible.

Rectal
Prophylaxis of postoperative anaerobic
bacterial infections
Child: 5-10 yr 500 mg 2 hr before surgery,
repeated 8 hrly for 3 days, then 12 hrly
thereafter until oral medication is possible.