Drug interactions between Inderide and Mi-Acid II
| Results for the following 2 drugs: |
|---|
| Inderide (hydrochlorothiazide/propranolol) |
| Mi-Acid II (aluminum hydroxide/magnesium hydroxide/simethicone) |
Interactions between your selected drugs
hydrochlorothiazide ↔ magnesium hydroxide
Applies to:Inderide (hydrochlorothiazide/propranolol) and Mi-Acid II (aluminum hydroxide/magnesium hydroxide/simethicone)
MONITOR: The chronic use or abuse of laxatives may potentiate the pharmacologic effects of diuretics. Laxatives can cause significant losses of fluid and electrolytes, including sodium, potassium, magnesium and zinc, and these effects may be additive to those of diuretics.
MANAGEMENT: In general, laxatives should only be used on a short-term, intermittent basis in recommended dosages. During concomitant use with diuretics, patients should be advised to contact their physician if they experience signs and symptoms of fluid and electrolyte depletion such as dizziness, lightheadedness, dry mouth, thirst, fatigue, weakness, lethargy, muscle cramps, decreased urination, postural hypotension, and tachycardia. If maintenance of bowel regularity is required, patients should be advised to exercise and increase fiber in the diet and/or consider the use of bulk-forming laxatives.
propranolol ↔ aluminum hydroxide
Applies to:Inderide (hydrochlorothiazide/propranolol) and Mi-Acid II (aluminum hydroxide/magnesium hydroxide/simethicone)
Concurrent administration with aluminum and magnesium antacids has been shown to decrease the oral bioavailability of certain beta-blockers, although data are conflicting. The exact mechanism of interaction is unknown but may involve cation binding of beta-blockers or a reduction in the dissolution rate due to increased gastric pH. In six healthy volunteers, concomitant administration of a single dose of antacid (magnesium hydroxide-aluminum oxide 1200 mg-1800 mg) reduced the peak plasma concentration (Cmax), area under the concentration-time curve (AUC) and 24-hour urinary excretion of sotalol (160 mg) by 27%, 21% and 9%, respectively, while administration of the antacid 2 hours after the sotalol dose produced no change. Pharmacodynamic data suggest that the negative chronotropic effect of sotalol was also reduced up to 4 hours after administration of the combination, although the lack of a placebo control might have confounded the results. In another study, concomitant administration of an aluminum hydroxide antacid in six healthy volunteers decreased atenolol (100 mg) Cmax and AUC by 37% and 33%, respectively. However, the Cmax and AUC of metoprolol (100 mg) in the same group was increased 25% and 11%, respectively, by administration of the antacid. Two other studies with aluminum hydroxide failed to find a significant effect on pharmacokinetics or pharmacodynamics of atenolol and propranolol. Based on available data, the clinical significance of this potential interaction is difficult to determine. As a precaution, patients may want to consider separating the administration times of beta-blockers and antacids or other aluminum- or magnesium-containing products by at least 2 hours.
propranolol ↔ magnesium hydroxide
Applies to:Inderide (hydrochlorothiazide/propranolol) and Mi-Acid II (aluminum hydroxide/magnesium hydroxide/simethicone)
Concurrent administration with aluminum and magnesium antacids has been shown to decrease the oral bioavailability of certain beta-blockers, although data are conflicting. The exact mechanism of interaction is unknown but may involve cation binding of beta-blockers or a reduction in the dissolution rate due to increased gastric pH. In six healthy volunteers, concomitant administration of a single dose of antacid (magnesium hydroxide-aluminum oxide 1200 mg-1800 mg) reduced the peak plasma concentration (Cmax), area under the concentration-time curve (AUC) and 24-hour urinary excretion of sotalol (160 mg) by 27%, 21% and 9%, respectively, while administration of the antacid 2 hours after the sotalol dose produced no change. Pharmacodynamic data suggest that the negative chronotropic effect of sotalol was also reduced up to 4 hours after administration of the combination, although the lack of a placebo control might have confounded the results. In another study, concomitant administration of an aluminum hydroxide antacid in six healthy volunteers decreased atenolol (100 mg) Cmax and AUC by 37% and 33%, respectively. However, the Cmax and AUC of metoprolol (100 mg) in the same group was increased 25% and 11%, respectively, by administration of the antacid. Two other studies with aluminum hydroxide failed to find a significant effect on pharmacokinetics or pharmacodynamics of atenolol and propranolol. Based on available data, the clinical significance of this potential interaction is difficult to determine. As a precaution, patients may want to consider separating the administration times of beta-blockers and antacids or other aluminum- or magnesium-containing products by at least 2 hours.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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