<http://linked.opendata.cz/resource/sukl/spc/section/SPC103664_doc-4-5>	<http://salt.semanticauthoring.org/ontologies/sdo#hasParagraph>	<http://linked.opendata.cz/resource/sukl/spc/paragraph/SPC103664_doc-4-5-48> .
<http://linked.opendata.cz/resource/sukl/spc/section/SPC103664_doc-4-5>	<http://salt.semanticauthoring.org/ontologies/sdo#hasParagraph>	<http://linked.opendata.cz/resource/sukl/spc/paragraph/SPC103664_doc-4-5-6> .
<http://linked.opendata.cz/resource/sukl/spc/section/SPC103664_doc-4-5>	<http://salt.semanticauthoring.org/ontologies/sdo#hasParagraph>	<http://linked.opendata.cz/resource/sukl/spc/paragraph/SPC103664_doc-4-5-8> .
<http://linked.opendata.cz/resource/sukl/spc/section/SPC103664_doc-4-5>	<http://salt.semanticauthoring.org/ontologies/sdo#hasText>	"Vliv jin\u00FDch p\u0159\u00EDpravk\u016F na ciprofloxacin:\nTvorba chel\u00E1tov\u00FDch komplex\u016F\nSoub\u011B\u017En\u00E9 pod\u00E1v\u00E1n\u00ED ciprofloxacinu (peror\u00E1ln\u011B) s l\u00E9ky a miner\u00E1ln\u00EDmi dopl\u0148ky, kter\u00E9 obsahuj\u00ED v\u00EDcemocn\u00E9 kationy (nap\u0159. kalcium, ho\u0159\u010D\u00EDk, hlin\u00EDk, \u017Eelezo), polymern\u00EDmi vaza\u010Di fosf\u00E1t\u016F (nap\u0159. sevelamer), sukralf\u00E1tem nebo antacidy a s l\u00E9\u010Div\u00FDmi p\u0159\u00EDpravky ve vysoce pufrovan\u00E9 form\u011B (nap\u0159. tablety didanosinu) s\u00A0obsahem ho\u0159\u010D\u00EDku, hlin\u00EDku nebo kalcia, vede ke sn\u00ED\u017Een\u00ED vst\u0159eb\u00E1v\u00E1n\u00ED ciprofloxacinu. Proto se ciprofloxacin mus\u00ED u\u017E\u00EDvat bu\u010F 1 \u2013 2 hodiny p\u0159ed nebo alespo\u0148 4 hodiny po u\u017Eit\u00ED t\u011Bchto p\u0159\u00EDpravk\u016F. Toto omezen\u00ED neplat\u00ED pro antacida z \u0159ady blok\u00E1tor\u016F H2 receptor\u016F.\nStrava a ml\u00E9\u010Dn\u00E9 v\u00FDrobky\nV\u00E1pn\u00EDk, kter\u00FD je sou\u010D\u00E1st\u00ED stravy, neovliv\u0148uje v\u00FDrazn\u011B vst\u0159eb\u00E1v\u00E1n\u00ED. Nicm\u00E9n\u011B je t\u0159eba se vyhnout sou\u010Dasn\u00E9mu pod\u00E1v\u00E1n\u00ED ml\u00E9\u010Dn\u00FDch v\u00FDrobk\u016F nebo n\u00E1poj\u016F obohacen\u00FDch miner\u00E1ly (nap\u0159. ml\u00E9ko, jogurt, pomeran\u010Dov\u00FD d\u017Eus obohacen\u00FD o kalcium) s ciprofloxacinem, proto\u017Ee mohou sni\u017Eovat jeho vst\u0159eb\u00E1v\u00E1n\u00ED.\nProbenecid\nProbenecid interferuje s ren\u00E1ln\u00ED sekrec\u00ED ciprofloxacinu. Soub\u011B\u017En\u00E9 u\u017E\u00EDv\u00E1n\u00ED probenecidu a ciprofloxacinu vede ke zv\u00FD\u0161en\u00ED s\u00E9rov\u00E9 koncentrace ciprofloxacinu.\nVliv ciprofloxacinu na jin\u00E9 l\u00E9\u010Div\u00E9 p\u0159\u00EDpravky:\nTizanidin\nTizanidin se nesm\u00ED pod\u00E1vat sou\u010Dasn\u011B s ciprofloxacinem (viz bod 4.3). V klinick\u00E9 studii se zdrav\u00FDmi jedinci do\u0161lo ke zv\u00FD\u0161en\u00ED s\u00E9rov\u00E9 koncentrace tizanidinu (hodnota Cmax se zv\u00FD\u0161ila: 7kr\u00E1t, rozmez\u00ED: 4 a\u017E 21kr\u00E1t; hodnota AUC se zv\u00FD\u0161ila: 10kr\u00E1t, rozmez\u00ED: 6 a\u017E 24kr\u00E1t) p\u0159i sou\u010Dasn\u00E9m pod\u00E1v\u00E1n\u00ED s ciprofloxacinem. Zv\u00FD\u0161en\u00E1 s\u00E9rov\u00E1 koncentrace tizanidinu je spojena s umocn\u011Bn\u00FDm hypotenzitivn\u00EDm a sedativn\u00EDm efektem.\nMethotrexat\nRen\u00E1ln\u00ED tubul\u00E1rn\u00ED transport methotrexatu m\u016F\u017Ee b\u00FDt inhibov\u00E1n sou\u010Dasn\u00FDm pod\u00E1n\u00EDm ciprofloxacinu, co\u017E m\u016F\u017Ee v\u00E9st k zv\u00FD\u0161en\u00FDm plazmatick\u00FDm hladin\u00E1m methotrexatu a zv\u00FD\u0161it riziko toxick\u00FDch reakc\u00ED souvisej\u00EDc\u00EDch s methotrexatem. Proto se sou\u010Dasn\u00E9 pod\u00E1v\u00E1n\u00ED nedoporu\u010Duje (viz bod 4.4).\nTeofylin\nSou\u010Dasn\u00E9 pod\u00E1v\u00E1n\u00ED ciprofloxacinu a teofylinu m\u016F\u017Ee zp\u016Fsobit ne\u017E\u00E1douc\u00ED zv\u00FD\u0161en\u00ED s\u00E9rov\u00E9 koncentrace teofylinu. To m\u016F\u017Ee v\u00E9st k ne\u017E\u00E1douc\u00EDm \u00FA\u010Dink\u016Fm vyvolan\u00FDch teofylinem. Ve vz\u00E1cn\u00FDch p\u0159\u00EDpadech mohou b\u00FDt tyto ne\u017E\u00E1douc\u00ED \u00FA\u010Dinky \u017Eivot ohro\u017Euj\u00EDc\u00ED nebo i smrteln\u00E9. P\u0159i sou\u010Dasn\u00E9mu pod\u00E1v\u00E1n\u00ED t\u011Bchto dvou l\u00E9k\u016F se mus\u00ED kontrolovat s\u00E9rov\u00E9 koncentrace teofylinu a d\u00E1vky teofylinu mus\u00ED b\u00FDt p\u0159\u00EDpadn\u011B vhodn\u011B sn\u00ED\u017Eeny (viz bod 4.4).\nDal\u0161\u00ED deriv\u00E1ty xantinu\nByly zaznamen\u00E1ny p\u0159\u00EDpady, kdy p\u0159i sou\u010Dasn\u00E9m u\u017E\u00EDv\u00E1n\u00ED ciprofloxacinu a kofeinu nebo pentoxifylinu (oxpentifylinu) do\u0161lo ke zv\u00FD\u0161en\u00ED s\u00E9rov\u00E9 koncentrace t\u011Bchto deriv\u00E1t\u016F xantinu.\nFenytoin\nSou\u010Dasn\u00E9 u\u017E\u00EDv\u00E1n\u00ED ciprofloxacinu a fenytoinu m\u016F\u017Ee v\u00E9st ke zv\u00FD\u0161en\u00ED nebo sn\u00ED\u017Een\u00ED s\u00E9rov\u00FDch hladin fenytoinu, proto se doporu\u010Duje sledovat hladiny l\u00E9k\u016F.\nPeror\u00E1ln\u00ED antikoagulancia\nSou\u010Dasn\u00E9 pod\u00E1v\u00E1n\u00ED ciprofloxacinu a warfarinu m\u016F\u017Ee umoc\u0148ovat jeho antikoagula\u010Dn\u00ED efekt. Bylo hl\u00E1\u0161eno velk\u00E9 mno\u017Estv\u00ED p\u0159\u00EDpad\u016F vykazuj\u00EDc\u00EDch zv\u00FD\u0161en\u00ED aktivity peror\u00E1ln\u00EDch antikoagulanci\u00ED u pacient\u016F u\u017E\u00EDvaj\u00EDc\u00EDch antibiotika, v\u010Detn\u011B fluorochinolon\u016F. Velikost rizika z\u00E1vis\u00ED na prob\u00EDhaj\u00EDc\u00ED infekci, v\u011Bku a celkov\u00E9m stavu pacienta. Proto je t\u011B\u017Ek\u00E9 stanovit, pod\u00EDl fluorochinolon\u016F na n\u00E1r\u016Fstu INR (international normalised ratio). Proto se v pr\u016Fb\u011Bhu sou\u010Dasn\u00E9ho pod\u00E1v\u00E1n\u00ED ciprofloxacinu s peror\u00E1ln\u00EDmi antikoagulancii, ale i kr\u00E1tce po jeho ukon\u010Den\u00ED, doporu\u010Duje \u010Dast\u011Bj\u0161\u00ED sledov\u00E1n\u00ED protrombinov\u00E9ho \u010Dasu (INR), a pokud je to nutn\u00E9, upravit peror\u00E1ln\u00ED d\u00E1vky antikoagula\u010Dn\u00EDch p\u0159\u00EDpravk\u016F.\nRopinirol\nV klinick\u00E9 studii bylo prok\u00E1z\u00E1no, \u017Ee soub\u011B\u017En\u00E9 u\u017E\u00EDv\u00E1n\u00ED ropinirolu a ciprofloxacinu, st\u0159edn\u011B siln\u00E9ho inhibitoru izoenzymu CYP450 1A2, m\u00E1 za n\u00E1sledek zv\u00FD\u0161en\u00ED hodnot Cmax a AUC ropinirolu o 60 %, resp. 84 %. B\u011Bhem sou\u010Dasn\u00E9 l\u00E9\u010Dby s ciprofloxacinem, i kr\u00E1tce po jej\u00EDm ukon\u010Den\u00ED, se doporu\u010Duje klinick\u00E9 sledov\u00E1n\u00ED a p\u0159\u00EDpadn\u011B vhodn\u00E1 \u00FAprava d\u00E1vek ropinirolu (viz bod 4.4).\nClozapin\nPo sedmidenn\u00EDm sou\u010Dasn\u00E9m u\u017E\u00EDv\u00E1n\u00ED 250 mg ciprofloxacinu s clozapinem, se zv\u00FD\u0161ily s\u00E9rov\u00E9 koncentrace clozapinu a N-desmetylclozapinu o 29 %, resp. 31 %. B\u011Bhem sou\u010Dasn\u00E9 l\u00E9\u010Dby clozapinem a ciprofloxacinem, i kr\u00E1tce po jej\u00EDm ukon\u010Den\u00ED, se doporu\u010Duje klinick\u00E9 pozorov\u00E1n\u00ED a vhodn\u00E1 \u00FAprava d\u00E1vek clozapinu (viz bod 4.4).\n"@cs .
<http://linked.opendata.cz/resource/sukl/spc/section/SPC103664_doc-4-5>	<http://salt.semanticauthoring.org/ontologies/sdo#hasSectionTitle>	"4.5\tInterakce s\u00A0jin\u00FDmi l\u00E9\u010Div\u00FDmi p\u0159\u00EDpravky a jin\u00E9 formy interakce"@cs .
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<http://linked.opendata.cz/resource/sukl/spc/section/SPC103664_doc-4-5>	<http://salt.semanticauthoring.org/ontologies/sdo#hasOrderNumber>	"004.005" .
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<http://linked.opendata.cz/resource/sukl/spc/section/SPC103664_doc-4-5>	<http://salt.semanticauthoring.org/ontologies/sdo#hasParagraph>	<http://linked.opendata.cz/resource/sukl/spc/paragraph/SPC103664_doc-4-5-14> .
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<http://linked.opendata.cz/resource/sukl/spc/section/SPC103664_doc-4-5>	<http://salt.semanticauthoring.org/ontologies/sdo#hasParagraph>	<http://linked.opendata.cz/resource/sukl/spc/paragraph/SPC103664_doc-4-5-20> .
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