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Caltrate 600 with Iron and Vitamin D (calcium / ferrous fumarate / vitamin d) Disease Interactions

There are 13 disease interactions with Caltrate 600 with Iron and Vitamin D (calcium / ferrous fumarate / vitamin d):

Major

Calcium salts (applies to Caltrate 600 with Iron and Vitamin D) calcium- phosphate calcifications

Major Potential Hazard, High plausibility. Applicable conditions: Phosphate Imbalance

Elevated serum concentrations of calcium and phosphate can exceed the solubility level and result in calcium- phosphate precipitates that deposit in vascular and renal systems as well as other soft tissues of the body. Therapy with calcium should be administered with extreme caution in patients with hyperphosphatemia (hypoparathyroidism or severe renal impairment). Administration of oral calcium acetate or calcium carbonate, in addition to providing calcium, complexes phosphates within the GI tract. These complexes are eliminated in the feces. Clinical monitoring of serum calcium and phosphate concentrations is necessary.

References

  1. "Product Information. Posture (calcium phosphate, triphasic)." Whitehall-Robbins, Madison, NJ.
  2. "Product Information. Neo-Calglucon (calcium glubionate)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
Major

Calcium salts (applies to Caltrate 600 with Iron and Vitamin D) cardiac contraction/conduction

Major Potential Hazard, High plausibility. Applicable conditions: Arrhythmias

Calcium is involved in cardiac muscle contraction and electrical impulse conduction. Therapy with calcium salt formulations (particularly IV) should be administered cautiously to patients with cardiac disease. Patients receiving cardiac glycosides and concomitant IV calcium may experience arrhythmias. Therapy with IV calcium should be administered slowly and at reduced dosages in patients with cardiac disease.

References

  1. "Product Information. Posture (calcium phosphate, triphasic)." Whitehall-Robbins, Madison, NJ.
  2. "Product Information. Neo-Calglucon (calcium glubionate)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
Major

Calcium salts (applies to Caltrate 600 with Iron and Vitamin D) malabsorption

Major Potential Hazard, High plausibility. Applicable conditions: Achlorhydria, Malabsorption Syndrome

Calcium is absorbed from the intestinal tract by active transport and passive diffusion. Malabsorption syndromes (celiac disease, GI resection), deficiency of vitamin D, parathyroid hormone, or calcitonin, or an alkaline gastric pH (achlorhydria, carbonate or phosphate salts) can decrease the absorption of oral formulations of calcium. Calcium is available in oral and parenteral formulations.

References

  1. "Product Information. Neo-Calglucon (calcium glubionate)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  2. "Product Information. Posture (calcium phosphate, triphasic)." Whitehall-Robbins, Madison, NJ.
Major

Calcium salts (applies to Caltrate 600 with Iron and Vitamin D) renal dysfunction

Major Potential Hazard, High plausibility.

Absorption of oral calcium formulations may be altered and elimination of calcium by the kidney decreased with renal impairment. Hyperphosphatemia occurs during renal failure. Calcium acetate or calcium carbonate, in addition to providing calcium, complexes phosphates within the GI tract. Calcium carbonate can partially correct metabolic acidosis associated with chronic renal failure. Clinical monitoring of renal function and serum calcium and phosphate concentrations is necessary.

References

  1. "Product Information. Neo-Calglucon (calcium glubionate)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  2. "Product Information. Posture (calcium phosphate, triphasic)." Whitehall-Robbins, Madison, NJ.
Major

Calcium salts (applies to Caltrate 600 with Iron and Vitamin D) sarcoidosis

Major Potential Hazard, High plausibility.

Hypercalciuria, with or without hypercalcemia, may occasionally occur in patients with sarcoidosis. Elevated calcium levels may result from increased intestinal absorption of calcium, which is related to the extrarenal production of vitamin D by mononuclear phagocytes present within the sarcoid granuloma. Therapy with calcium salts should be administered cautiously and only if necessary in patients with sarcoidosis.

References

  1. "Product Information. Neo-Calglucon (calcium glubionate)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  2. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
  3. "Product Information. Posture (calcium phosphate, triphasic)." Whitehall-Robbins, Madison, NJ.
Major

Ferrous salts (applies to Caltrate 600 with Iron and Vitamin D) hemoglobin abnormalities

Major Potential Hazard, High plausibility. Applicable conditions: Hemoglobinopathy, Blood Transfusion

There is no excretory mechanism for iron. Iron will correct only hemoglobin abnormalities due to iron deficiency and should not be used to treat conditions such as thalassemia, hemosiderosis, hemochromatosis, normocytic anemia (unless iron deficiency exists), or in patients receiving blood transfusions. Clinical monitoring of erythropoietic function and ferritin levels is recommended.

References

  1. "Product Information. INFeD (iron dextran)." Schein Pharmaceuticals Inc, Florham Park, NJ.
Major

Vitamin D analogs (applies to Caltrate 600 with Iron and Vitamin D) arrhythmia

Major Potential Hazard, High plausibility. Applicable conditions: Arrhythmias

Vitamin D analogs function to increase serum calcium concentrations and can exacerbate arrhythmias, particularly in patients receiving cardiac glycosides. Therapy with vitamin D analogs should be administered cautiously in patients with or predisposed to cardiac arrhythmias. Clinical monitoring of serum electrolyte concentrations and cardiac function is recommended.

References

  1. "Product Information. Rocaltrol (calcitriol)." Roche Laboratories, Nutley, NJ.
  2. "Product Information. Calderol (calcifediol)." Organon, West Orange, NJ.
  3. "Product Information. Calciferol (ergocalciferol)." Schwarz Pharma, Mequon, WI.
Major

Vitamin D analogs (applies to Caltrate 600 with Iron and Vitamin D) electrolyte imbalance

Major Potential Hazard, High plausibility. Applicable conditions: Phosphate Imbalance

Vitamin D analogs administered in the presence of hyperphosphatemia can result in precipitation of calcium-phosphate deposits within the vascular or renal systems or other soft tissue calcifications. A solubility product (Serum Calcium X Phosphate) should not exceed 70. Serum electrolyte concentrations should be corrected prior to vitamin D analog therapy and monitored during therapy.

References

  1. "Product Information. Calciferol (ergocalciferol)." Schwarz Pharma, Mequon, WI.
  2. "Product Information. Zemplar (paricalcitol)." Abbott Pharmaceutical, Abbott Park, IL.
  3. "Product Information. Rocaltrol (calcitriol)." Roche Laboratories, Nutley, NJ.
  4. "Product Information. Calderol (calcifediol)." Organon, West Orange, NJ.
View all 4 references
Major

Vitamin D analogs (applies to Caltrate 600 with Iron and Vitamin D) hypercalcemia

Major Potential Hazard, Moderate plausibility. Applicable conditions: Malabsorption Syndrome

Vitamin D analogs such as calciferol and ergocalciferol should not be given to patients with hypercalcemia, malabsorption syndrome, or evidence of vitamin D toxicity.

Major

Vitamin D analogs (applies to Caltrate 600 with Iron and Vitamin D) renal dysfunction

Major Potential Hazard, High plausibility.

Ergocalciferol, cholecalciferol, and calcifediol undergo renal biotransformation during metabolic activation. Renal impairment can alter metabolic and therapeutic activity of certain vitamin D analogs. Alternative vitamin D analogs such as dihydrotachysterol (hepatic activation) and calcitriol (active form) may be considered in patients with compromised renal function.

References

  1. "Product Information. Calciferol (ergocalciferol)." Schwarz Pharma, Mequon, WI.
  2. "Product Information. Calderol (calcifediol)." Organon, West Orange, NJ.
  3. "Product Information. Rocaltrol (calcitriol)." Roche Laboratories, Nutley, NJ.
Moderate

Ferrous salts (applies to Caltrate 600 with Iron and Vitamin D) achlorhydria

Moderate Potential Hazard, Moderate plausibility.

Gastric acidity increases iron bioavailability by maintaining the ingested iron in a reduced form as ferrous ions, which are more readily absorbed than ferric ions. Therefore, when iron therapy is administered orally, higher dosages may be necessary for patients with decreased gastric acid production. Also, a liquid formulation is recommended in these patients because dissolution of the tablet coating depends on normal gastric acidity.

References

  1. "Product Information. Feosol Tablets (ferrous sulfate)." SmithKline Beecham, Philadelphia, PA.
Moderate

Ferrous salts (applies to Caltrate 600 with Iron and Vitamin D) gastrointestinal irritation

Moderate Potential Hazard, High plausibility. Applicable conditions: Peptic Ulcer, Colitis/Enteritis (Noninfectious)

Iron can be irritating and damaging to gastrointestinal mucosa. Iron therapy should be administered cautiously in patients with peptic ulcer disease, enteritis, or ulcerative colitis.

References

  1. "Product Information. Feosol Tablets (ferrous sulfate)." SmithKline Beecham, Philadelphia, PA.
Moderate

Vitamin D analogs (applies to Caltrate 600 with Iron and Vitamin D) hepatobiliary dysfunction

Moderate Potential Hazard, High plausibility. Applicable conditions: Liver Disease, Biliary Obstruction

Vitamin D analogs are fat soluble and oral formulations require bile for adequate intestinal absorption. Hepatic and/or biliary dysfunction decrease the absorption of vitamin D analogs. Metabolites of vitamin D analogs are primarily excreted in bile and feces. Ergocalciferol, cholecalciferol, and dihydrotachysterol undergo hepatic hydroxylation during metabolic activation. Hepatic impairment can alter the metabolic and therapeutic activity of certain vitamin D analogs. Alternative vitamin D analogs such as calcifediol (requires renal activation) and calcitriol (active form) may be considered in patients with compromised hepatic function.

References

  1. "Product Information. Rocaltrol (calcitriol)." Roche Laboratories, Nutley, NJ.
  2. "Product Information. Calciferol (ergocalciferol)." Schwarz Pharma, Mequon, WI.
  3. "Product Information. Calderol (calcifediol)." Organon, West Orange, NJ.

Caltrate 600 with Iron and Vitamin D (calcium / ferrous fumarate / vitamin d) drug interactions

There are 283 drug interactions with Caltrate 600 with Iron and Vitamin D (calcium / ferrous fumarate / vitamin d)

Caltrate 600 with Iron and Vitamin D (calcium / ferrous fumarate / vitamin d) alcohol/food interactions

There are 2 alcohol/food interactions with Caltrate 600 with Iron and Vitamin D (calcium / ferrous fumarate / vitamin d)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.