Dental Drug Interactions: Decreased absorption of ketoconazole, itraconazole and valium, increased toxicity of versed. Variable effects on warfarin.
Cimetidine (Tagamet) Decreases tetracycline absorption, increases blood levels alcohol, diazepam and narcotic analgesics.
Nizatidine (Axid) #92 in 97’
Famotidine (Pepcid) #50 in 97’ Dry mouth, taste changes, paresthesia, tinnitus, myalgia
Action: Gastric parietal cell pump inhibited less gastric acid secretion.
Use: Treat peptic and gastric ulcer disease, severe erosive esophagitis, gastroesophageal reflux disease, hypersecretory conditions and NSAID induced ulcers.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Headache, dry mouth, taste alterations, mucosal atrophy of tongue, candidiasis, tinnitus, myalgia, arthralgia and fever.
Dental Drug Interactions: Decreased effect of ketoconazole and itraconazole, increased effect of valium, coumadin.
Rabeprazole (Aciphex) facial edema, gingivitis, glossitis, paresthesia, photosensitivity, salivary gland enlargement
Action: Sulfasalazine has high affinity for connective tissue and serous fluid, liver and intestinal walls. The principle metabolites of this sulfonamide derivative are sulfapyridine and 5-aminosalicyclic acid (the anti-inflammatory agent).
Use: Treat ulcerative colitis, Crohn’s disease and rheumatoid arthritis.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Headache, fever, chills, Stevens-Johnson syndrome, blood dyscrasias.
Sulfasalazine (Azulfidine) (continued)
Dental Drug Interactions: Decreases effect of oral anticoagulants, ester type local anesthetics (procaine, tetracaine) and penicillins and cephalosporins. Increases tetracycline photosensitizing effect.
Mesalamine (Asacol, Pentasa, Rowasa)
Action: 5-aminosalicyclic acid, works topically to modulate chemical mediators of
Use: Treat ulcerative colitis, proctosigmoiditis, and proctosis.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Headache, blood
Dental Drug Interactions: None
Action: Blocks action of acetycholine at parasympathetic sites in smooth muscle, secretory glands and the CNS. Functions as GI antispasmodic agent.
Use: Treat irritable bowel syndrome, urinary incontinence, infant colic, in combination with other drugs for peptic ulcer disease.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Dry mouth, throat and nose, headache, dysphagia, photophobia, fever and orthostatic hypotension.
Dental Drug Interactions: Increases toxicity of narcotics, antihistamines, other anticholinergics. Decreases effects of ketoconazole.
Dicyclomine (Bentyl, Antispas)
Clidinium** and Chlordiazepoxide* (Librax) *Is the benzodiazepine Librium **Taste alterations
Action: Inhibits destruction of acetylcholine thus increasing acetylcholine concentration.
Use: Nondepolarizing muscle relaxant antagonist, myasthenia gravis.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Salivation, tongue
weakness, headache, bronchospasm and laryngospasm.
Dental Drug Interactions: Decreases effects of anticholinergics. Reduces rate of
metabolism of ester local anesthetics.
Action: Binds to an inflammatory cytokine.
Use: Treat rheumatoid arthritis and Crohn’s disease.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Candidiasis,
headache, fever, TMJ-myalgia, pharyngitis, sinusitis.
Dental Drug Interactions: None
Infliximab ( Remicade)
Action: Blocks dopamine receptors in chemoreceptor trigger zone of CNS.
Enhances response to acetylcholine in upper GI tract enhancing motility and gastric emptying without simultaneous gastric, biliary or pancreatic secretion.
Use: Treat diabetic gastric stasis, gastroesophageal reflux, prevent nausea from chemotherapy, radiation and post surgery.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Dry mouth, headache and blood dyscrasias.
Dental Drug Interactions: Decreased GI action with anticholinergics, opiods. Increased sedation with alcohol and other CNS depressants.
Action: Probably inhibits vomiting center in medulla oblongata
Use: When conventional antiemetics fail to relieve nausea and vomiting associated with cancer chemotherapy, AIDs related anorexia
Dental Considerations: Local anesthesia with vasoconstrictor ok. Orthostatic
hypotension, headache, dry mouth, paresthesia, myalgia and tinnitus.
Dental Drug Interactions: Increased drowsiness with alcohol, barbiturates and