Drug Interactions between Advanced Formula Di-Gel and trientine

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.

ADJUST DOSING INTERVAL: The gastrointestinal absorption of trientine may be decreased in the presence of food, resulting in reduced therapeutic effects.

MANAGEMENT: Trientine should be administered on an empty stomach, at least one hour before or two hours after meals and at least one hour apart from any other food, drug, or milk.

GENERALLY AVOID: Concurrent oral administration of mineral supplements or mineral-containing products may block the absorption of trientine, and vice versa. The mechanism is trientine chelation of polyvalent metal ions resulting in a nonabsorbable complex.

MANAGEMENT: In general, mineral supplements or mineral-containing products (e.g., antacids) should not be used in patients treated with trientine. If concomitant use is unavoidable, separation of administration times by at least two hours is advisable.