Interactions between iberet(multivitamin with iron) and Calcium oyster shell (calcium carbonate)
calcium carbonate and multivitamin with iron (Moderate Drug-Drug)
ADJUST DOSING INTERVAL: The bioavailability of orally administered iron may be reduced by concomitant administration of an antacid or other agents with acid-neutralizing effects. The interaction has been suspected in some patients with diminished hematologic response to iron therapy. The exact mechanism is unknown but may involve reduced iron solubility due to increase in gastric pH or complexation of the iron. Based on existing data, sodium bicarbonate and calcium carbonate appear to have greater effects than antacids containing magnesium and aluminum hydroxide, which have been reported to have minimal to moderate effect on iron absorption. The interaction reportedly does not occur in the presence of ascorbic acid, which may competitively bind with iron and prevent the interference with iron absorption.
MANAGEMENT: To minimize the potential for interaction, it may be appropriate to administer oral iron preparations at least two hours apart from antacids or other agents with acid-neutralizing effects.
