PRECAUTIONS: Before using quinupristin/dalfopristin, tell your doctor or pharmacist if you are allergic to it; or to other streptogramin antibiotics (e.g., pristinamycin, virginiamycin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver problems, high levels of bilirubin in the blood (hyperbilirubinemia).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: See also How to Use.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: digoxin.This drug can slow down the removal of certain medications from your body by affecting certain liver enzymes. These affected drugs include those that may affect the heart rhythm (QTc prolongation in the EKG), infrequently resulting in serious (rarely fatal) irregular heartbeat. Quinupristin/dalfopristin should not be used with the following medications because very serious interactions may occur: certain antiarrhythmic drugs (e.g., amiodarone, disopyramide, quinidine), cisapride, certain macrolide antibiotics (e.g., erythromycin, clarithromycin), certain antipsychotics (e.g., haloperidol, pimozide).If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting quinupristin/dalfopristin.This drug can also slow down the removal of other drugs from your body by affecting certain liver enzymes. Before taking quinupristin/dalfopristin, tell your doctor or pharmacist if you are taking any of the following medications: certain drugs to suppress the immune system (e.g., cyclosporine, sirolimus, tacrolimus), certain drugs to treat HIV (e.g., delavirdine, indinavir, nevirapine, ritonavir), certain anti-cancer drugs (e.g., docetaxel, paclitaxel, vinblastine, vincristine), calcium channel blockers (e.g., diltiazem, nifedipine, verapamil), certain "statin" drugs to lower cholesterol (e.g., atorvastatin, lovastatin, simvastatin), certain benzodiazepines (e.g., diazepam, midazolam), carbamazepine, corticosteroids (e.g., methylprednisolone), drugs to treat erectile dysfunction-ED or pulmonary hypertension (e.g., sildenafil, tadalafil).Although most antibiotics probably do not affect hormonal birth control such as pills, patch, or ring, some antibiotics may decrease their effectiveness. This could cause pregnancy. Examples include rifamycins such as rifampin or rifabutin. Be sure to ask your doctor or pharmacist if you should use additional reliable birth control methods while using this antibiotic.
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