Code I: Interaction

Use of this product may alter the effect of other drugs and interfere with their effectiveness.

Drug Caution Code "I" refers to:
Calcium salts
Magnesium salts
Aluminum salts
Iron salts
Bismuth salts
Urinary alkalizers such as sodium bicarbonate, sodium citrate, potassium citrate
Adsorbent antidiarrheals such as attapulgite, kaolin and pectin.

Calcium Salts Interact With:

Interaction	Mechanism	Management
Etidronate	Calcium prevents absorption	Do not take within 2 hours of calcium supplements
Fluroquinolones	Decreased absorption	Do not take within 2 hours of calcium supplements
Iron salts (oral)	Decreased absorption	Do not take within 2 hours of calcium supplements
Phenytoin	Decreased bioavailability	Do not take within 3 hours
Tetracyclines	Decreased absorption	Separate administration by 3 to 4 hours
Verapamil	Decreased effect of Verapamil	Do not take within 2 hours

Magnesium Salts Interact With:

Interaction	Mechanism	Management
Aminoquinolones (chloroquine)	Chloroquine adsorbed by magnesium	Separate doses by 2 to 4 hours
Penicillamine	Decreased bioavailability	Take penicillamine on an empty stomach, unaccompanied by magnesium salts
Tetracyclines	Decreased absorption	Separate doses by 2 to 4 hours.

Aluminum Salts Interact With:

Interaction	Mechanism	Management
Tetracyclines	Decreased absorption	Separate doses by 3 to 4 hours.
Penicillamine	Decreased bioavailability	Separate doses, possibly increase penicillamine dose

Antacids Interact With:

Interaction	Mechanism	Management
Ketoconazole	Decreased bioavailability	Give antacids more than 2 hours after ketoconazole Efficacy of this not established
Quinidine	Increased serum quinidine Possible toxicity	Monitor serum quinidine during antacid therapy
Quinolones (ciprofloxacin, norfloxacin)	Decreased absorption	Give antacids at least 6 hours before or 2 hours after quinolones
Iron salts (oral)	Decreased absorption	Separate administration times.

Iron Salts Interact With:

Interaction	Mechanism	Management
Chloramphenicol	Decreased iron clearance	Choose another antimicrobial. Monitor iron levels.
Levodopa	Decreased absorption	Separate administration times. Increase dose of levodopa if clinical response is decreased.
Penicillamine	Decreased absorption	Take penicillamine on an empty stomach, unaccompanied by iron preparations
Quinolones	Decreased absorption	Avoid co-administration
Thyroid hormones	Decreased effect of levothyroxine	Separate administration Monitor thyroid function
Tetracyclines	Decreased absorption of both agents	Avoid co-administration Separate by 3 to 4 hours

Bismuth Salts Interact With:

Interaction	Mechanism	Management
Tetracyclines	Decreased serum levels	Avoid simultaneous administration. Give bismuth salts 2 hours after tetracyclines

Urinary Alkalizers Interact With:

Interaction	Mechanism	Management
Tetracyclines	Increased excretion	Separate use by 3 to 4 hours. Increased dose of tetracycline may be necessary.
Sympathomimetics (pseudoephedrine)	Decreased elimination of ephedrine and pseudoephedrine	Decrease dose of sympathomimetics
Sulfonureas (chlorpropamide)	Increased elimination of chlorpropamide	Dose may need to be increased. Monitor blood glucose levels during co-administration.
Salicylates	Increased renal clearance Decreased effect	Concurrent therapy may require increased salicylate dose.
Lithium	Decreased lithium plasma levels	AVOID! Watch for OTC antacids containing sodium bicarbonate
Anorexients	Prolonged effects of Amphetamines.	Avoid agents which may alkalinize the urine.

Digoxin Interacts With:

Interaction	Mechanism	Management
Kaolin-pectin antidiarrheals Antacids containing aluminum or magnesium Large quantities of dietary fibre, including bulk-forming laxatives Laxatives containing magnesium Lubricant laxatives such as mineral oil Charcoal	Physical adsorption of digoxin	Separate doses by 2 hours or more.

Mineral Oil Interactions

Mineral oil is a lipid solvent which may absorb drugs. With chronic use there is "fast" movement of food and drugs through the GI tract so there is not enough time for nutrients and drugs to be absorbed. The fat soluble vitamins A,D,E and K are affected. Vitamins should be given several hours before the mineral oil . Decreased Vitamin K absorption will increase the anticoagulant effect of coumadin. Use of mineral oil should be limited to less than 1 week.
Oral contraceptives can also be affected by absorption of estrogens by the mineral oil. This is only important with chronic use.
Mineral oil given at bedtime can cause lipid pneumonia, especially in elderly, pediatric, debilitated or dysphagia patients.

Other Interactions

Digoxin, salicylates, and nitrofurantoin are bound by cellulose containing products and their absorption is decreased. Psyllium products will bind coumadin. Leave at least 2 hours between doses.
Kaolin-pectin and attapulgite preparations can bind other drugs (especially digoxin and lincomycin). They should be given 2 hours before or 3 to 4 hours after the therapeutic agent to avoid adsorption.

Share and Enjoy

Tags

drug, drugs, medication, medicine, prescription, side effects, interactions, cautions, use, reference, pharmacy, pharmacist,non-prescription,over-the-counter,over the counter,otc,drug caution code,warning system,codes