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Drug Interactions between calcifediol and Carafate

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

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Interactions between your drugs

Moderate

sucralfate calcifediol

Applies to: Carafate (sucralfate) and calcifediol

MONITOR: In patients with advanced renal impairment or on dialysis, chronic use of aluminum-containing preparations during treatment with vitamin D analogs may result in increased blood levels of aluminum and aluminum toxicity. Patients with renal failure are at risk for toxicity due to impaired clearance of aluminum, and the risk may be further increased by the administration of vitamin D analogs due to increased intestinal absorption of aluminum. Toxicity may manifest as osteodystrophy, osteomalacia, myopathy, anemia, and encephalopathy.

MANAGEMENT: Concomitant use of vitamin D analogs and aluminum-containing preparations should be followed with monitoring for signs and symptoms of aluminum toxicity.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Moon J, Davison A, Bandy B "Vitamin D and aluminum absorption." CMAJ 147 (1992): 1308, 1313

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Drug and food interactions

Moderate

sucralfate food

Applies to: Carafate (sucralfate)

ADJUST DOSING INTERVAL: The administration of sucralfate with enteral nutrition may result in precipitation and the formation of bezoars that may obstruct feeding tubes. The proposed mechanism is the formation of an insoluble aluminum-protein complex between the aluminum in the sucralfate and the protein in the enteral feeding. In addition, sucralfate may not become activated due to the alkaline pH of enteral nutrition products.

MANAGEMENT: Some experts recommend separating the sucralfate doses from enteral feedings by at least 1 hour. Alternatively, consideration may be given to proton pump inhibitors or H2 antagonists.

References

  1. Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm 66 (2009): 1438-67

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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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