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Drug Interactions between Advanced Formula Di-Gel and cabotegravir

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

calcium carbonate cabotegravir

Applies to: Advanced Formula Di-Gel (calcium carbonate / magnesium hydroxide / simethicone) and cabotegravir

ADJUST DOSING INTERVAL: Coadministration with antacids, mineral supplements, or other medications containing polyvalent cations such as magnesium, aluminum, calcium, and iron may decrease the bioavailability of oral cabotegravir. The proposed mechanism involves chelation of cabotegravir by polyvalent cations, forming a complex that is poorly absorbed from the gastrointestinal tract. The interaction has not been studied with cabotegravir, but has been reported with other integrase strand transfer inhibitors (INSTIs).

MANAGEMENT: To minimize the risk of reduced viral susceptibility and resistance development associated with subtherapeutic levels of cabotegravir, medications containing polyvalent cations such as antacids and mineral supplements should be administered at least 2 hours before or 4 hours after the oral cabotegravir dose.

References (4)
  1. Cerner Multum, Inc. "Australian Product Information."
  2. Cerner Multum, Inc. (2015) "Canadian Product Information."
  3. US National Library of Medicine (2019) Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/287/insti-drug-interactions
  4. (2021) "Product Information. Vocabria (cabotegravir)." ViiV Healthcare
Major

magnesium hydroxide cabotegravir

Applies to: Advanced Formula Di-Gel (calcium carbonate / magnesium hydroxide / simethicone) and cabotegravir

ADJUST DOSING INTERVAL: Coadministration with antacids, mineral supplements, or other medications containing polyvalent cations such as magnesium, aluminum, calcium, and iron may decrease the bioavailability of oral cabotegravir. The proposed mechanism involves chelation of cabotegravir by polyvalent cations, forming a complex that is poorly absorbed from the gastrointestinal tract. The interaction has not been studied with cabotegravir, but has been reported with other integrase strand transfer inhibitors (INSTIs).

MANAGEMENT: To minimize the risk of reduced viral susceptibility and resistance development associated with subtherapeutic levels of cabotegravir, medications containing polyvalent cations such as antacids and mineral supplements should be administered at least 2 hours before or 4 hours after the oral cabotegravir dose.

References (4)
  1. Cerner Multum, Inc. "Australian Product Information."
  2. Cerner Multum, Inc. (2015) "Canadian Product Information."
  3. US National Library of Medicine (2019) Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/287/insti-drug-interactions
  4. (2021) "Product Information. Vocabria (cabotegravir)." ViiV Healthcare

Drug and food interactions

Moderate

calcium carbonate food

Applies to: Advanced Formula Di-Gel (calcium carbonate / magnesium hydroxide / simethicone)

ADJUST DOSING INTERVAL: Administration with food may increase the absorption of calcium. However, foods high in oxalic acid (spinach or rhubarb), or phytic acid (bran and whole grains) may decrease calcium absorption.

MANAGEMENT: Calcium may be administered with food to increase absorption. Consider withholding calcium administration for at least 2 hours before or after consuming foods high in oxalic acid or phytic acid.

References (6)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
  3. Cerner Multum, Inc. "Australian Product Information."
  4. Agencia Española de Medicamentos y Productos Sanitarios Healthcare (2008) Centro de información online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html
  5. Mangels AR (2014) "Bone nutrients for vegetarians." Am J Clin Nutr, 100, epub
  6. Davies NT (1979) "Anti-nutrient factors affecting mineral utilization." Proc Nutr Soc, 38, p. 121-8

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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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.

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