Drug Interactions between aluminum hydroxide / magnesium hydroxide / simethicone and sodium polystyrene sulfonate

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, and 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.

Foods high in potassium such as orange juice and other fruit juices may reduce the effectiveness of sodium polystyrene sulfonate in treating your condition. Do not mix sodium polystyrene sulfonate in fruit juice or drink fruit juice with it. Also, sodium polystyrene sulfonate may interfere with the absorption of other medications that you take by mouth, including both prescription medications such as antibiotics, blood pressure/heart medications and blood thinners, and over-the-counter products such as antacids and laxatives. This can lead to lower blood levels and reduced effects if you take them too closely together with sodium polystyrene sulfonate. It is recommended that you separate the dosing of sodium polystyrene sulfonate from other oral medications by at least 3 hours whenever possible. This interval should be increased to 6 hours if you have gastroparesis or other conditions that cause delayed emptying of food from the stomach into the intestine. Talk to your doctor or pharmacist 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.

Sodium polystyrene sulfonate can bind to calcium, iron, magnesium, and other minerals in the gastrointestinal tract. This may inactivate both sodium polystyrene sulfonate and the mineral it binds to and reduce the effectiveness of both medications. To avoid or minimize the interaction, the dosing times of sodium polystyrene sulfonate and multivitamin with minerals should be separated by several hours. Talk to your doctor if you have any questions or concerns, or if you have trouble separating the dosing times. Your doctor may be able to prescribe alternatives that do not interact. 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.