Skip to main content

Can you take Almacone-2 with Bitolterol?

1 drug interaction and 14 additional warnings found for the following 2 drugs:

Add/remove drugs

Drug interactions

Moderate drug interactions

Moderate:

bitolterol magnesium hydroxide

Applies to: bitolterol and Almacone-2 (aluminum hydroxide / magnesium hydroxide / simethicone)

Bitolterol can cause an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect.

The risk is increased if you have:

  • a heart condition called congenital long QT syndrome
  • other cardiac diseases
  • conduction abnormalities
  • electrolyte disturbances, such as low blood levels of magnesium or potassium

These electrolyte disturbances can occur with bowel cleansing preparations or excessive use of medications that have a laxative effect, such as magnesium hydroxide.

Do not exceed the dose and duration recommended on the product label or prescribed by your doctor.

You should seek immediate medical attention if you experience sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether taken together or separately.

In addition, you should let your doctor know if you experience signs and symptoms of low magnesium or potassium blood level such as:

  • weakness
  • tiredness
  • drowsiness
  • dizziness
  • confusion
  • tingling
  • numbness
  • muscle pain
  • cramps
  • nausea
  • vomiting

It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Food/lifestyle interactions

Major food/lifestyle interactions

Major:

aluminum hydroxide Food/Lifestyle

Applies to: Almacone-2 (aluminum hydroxide / magnesium hydroxide / simethicone)

Citrate, or citric acid, can increase the absorption of aluminum hydroxide. This may lead to elevated blood levels of aluminum, particularly in individuals with reduced kidney function, since aluminum is primarily eliminated by the kidneys.

Excess aluminum may deposit and cause problems in various tissues including:

  • bone
  • brain
  • heart
  • liver
  • muscles
  • spleen

Over time, weak bones, bone pain, fractures, skeletal deformity, brain disorders, and anemia may develop.

Talk to your doctor before using aluminum hydroxide if you have kidney impairment or are on hemodialysis.

You should avoid or limit the consumption of citrate-containing foods and beverages (e.G., soft drinks, citrus fruits, fruit juices) during treatment with aluminum hydroxide. Be aware that some effervescent and dispersible drug formulations may also contain citrate and should be restricted as well. Even if you do not have kidney problems, it may be best to separate the dosing of aluminum hydroxide and citrate-containing products by 2 to 3 hours.

Talk to a healthcare professional if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

When aluminum hydroxide is taken during enteral nutrition therapy (tube feeding), the tube may get clogged.

Therefore, aluminum hydroxide should not be mixed with or given after high-protein tube feedings. The dose should be separated from the feeding by as much as possible, and the tube should be thoroughly flushed before administration of the dose.

Moderate food/lifestyle interactions

Moderate:

bitolterol Caffeine

Applies to: bitolterol

Both bitolterol and caffeine can increase blood pressure and heart rate, and combining them may enhance these effects.

Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications.

Contact your doctor if your condition changes or you experience increased side effects.

It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Disease interactions

12 potential interactions Applies to: 11 conditions, including High Blood Pressure, Seizures, Hypokalemia, Hyperthyroidism, and Inflammatory Bowel Disease.

Diabetes Mellitus

Moderate:

bitolterol

Bitolterol has a moderate potential interaction with Diabetes Mellitus.

Adrenergic bronchodilators may cause increases in blood glucose concentrations. These effects are usually transient and slight, but may be significant with dosages higher than those normally recommended. Large doses of IV albuterol (not commercially available in the U.S.) and terbutaline sulfate have been reported to cause exacerbation of preexisting diabetes mellitus and ketoacidosis. Therapy with adrenergic bronchodilators should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.

Gastrointestinal Obstruction

Major:

Almacone-2

The magnesium hydroxide in Almacone-2 has a major potential interaction with Gastrointestinal Obstruction.

The use of laxatives is contraindicated in patients with intestinal obstruction disorders. Patients with intestinal obstruction disorders may need their underlying condition treated to correct the constipation. Some laxatives require reduction in the colon to their active form to be effective which may be a problem in patients with intestinal obstruction.

Heart Disease

Moderate:

bitolterol

Bitolterol has a moderate potential interaction with Heart Disease.

Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.

High Blood Pressure

Moderate:

bitolterol

Bitolterol has a moderate potential interaction with High Blood Pressure.

Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.

Hyperthyroidism

Moderate:

bitolterol

Bitolterol has a moderate potential interaction with Hyperthyroidism.

Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.

Hypokalemia

Moderate:

bitolterol

Bitolterol has a moderate potential interaction with Hypokalemia.

Adrenergic bronchodilators may cause decreases in serum potassium concentrations, primarily when given by nebulization or intravenous administration. Although this effect is usually transient and does not require supplementation, clinically significant hypokalemia may occur in some patients, with the potential to induce cardiovascular adverse effects. The relevance of these observations to oral or oral aerosol/powder for inhalation therapy is unknown. Therapy with adrenergic bronchodilators should be administered cautiously in patients with or predisposed to hypokalemia.

Inflammatory Bowel Disease

Major:

Almacone-2

The magnesium hydroxide in Almacone-2 has a major potential interaction with Inflammatory Bowel Disease.

The use of laxatives is contraindicated in patients with inflammatory bowel disease. Patients with inflammatory bowel disease may experience colonic perforation with use of stimulant laxatives.

Intestinal Obstruction

Major:

Almacone-2

The aluminum hydroxide in Almacone-2 has a major potential interaction with Intestinal Obstruction.

Aluminum containing antacids may produce constipation, which may lead to intestinal obstruction. Osteomalacia and hypophosphatemia may be produced in patients with renal dysfunction who are not receiving dialysis. Patients with renal dysfunction, intestinal obstruction, osteomalacia, or hypophosphatemia should use antacids with low or no aluminum content.

Phosphate Imbalance

Major:

Almacone-2

The aluminum hydroxide in Almacone-2 has a major potential interaction with Phosphate Imbalance.

Aluminum containing antacids may produce constipation, which may lead to intestinal obstruction. Osteomalacia and hypophosphatemia may be produced in patients with renal dysfunction who are not receiving dialysis. Patients with renal dysfunction, intestinal obstruction, osteomalacia, or hypophosphatemia should use antacids with low or no aluminum content.

Renal Dysfunction

Major:

Almacone-2

The aluminum hydroxide in Almacone-2 has a major potential interaction with Renal Dysfunction.

Aluminum containing antacids may produce constipation, which may lead to intestinal obstruction. Osteomalacia and hypophosphatemia may be produced in patients with renal dysfunction who are not receiving dialysis. Patients with renal dysfunction, intestinal obstruction, osteomalacia, or hypophosphatemia should use antacids with low or no aluminum content.

Major:

Almacone-2

The magnesium hydroxide in Almacone-2 has a major potential interaction with Renal Dysfunction.

Magnesium is eliminated by the kidney. The serum concentration of magnesium is increased in patients with renal impairment. Magnesium toxicity includes CNS depression, muscular paralysis, respiratory depression, hypotension and prolonged cardiac conduction time. Disappearance of the patellar reflex is a useful clinical sign of magnesium intoxication. Therapy with magnesium should be administered cautiously and dosages should be modified in patients with compromised renal function. Clinical monitoring of serum magnesium levels is recommended.

Seizures

Moderate:

bitolterol

Bitolterol has a moderate potential interaction with Seizures.

Adrenergic bronchodilators may cause CNS stimulation. Therapy with adrenergic bronchodilators should be administered cautiously in patients with seizure disorders. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.

More resources

Almacone-2

A total of 456 drugs are known to interact with Almacone-2.

bitolterol

A total of 396 drugs are known to interact with bitolterol.

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.