Interactions between aluminum-hydroxide(aluminum hydroxide) and Citracal liquitab (calcium citrate)
aluminum hydroxide and calcium citrate (Major Drug-Drug)
GENERALLY AVOID: The concomitant administration of aluminum-containing products (e.g., antacids and phosphate binders) and citrates may significantly increase serum aluminum concentrations, resulting in toxicity. Citrates enhance the gastrointestinal absorption of aluminum by an unknown mechanism, which may involve the formation of a soluble aluminum-citrate complex. Various studies have reported that citrate increases aluminum absorption by 4.6- to 50-fold in healthy subjects. Patients with end-stage renal disease are particularly at risk of developing hyperaluminemia and encephalopathy. Fatalities have been reported.
MANAGEMENT: The concomitant use of aluminum- and citrate-containing products should be avoided in renally impaired patients. Some experts also recommend that healthy patients should separate doses of aluminum-containing antacids and citrates by 2 to 3 hours.
