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Drug Interactions between calcium carbonate / psyllium and lactulose

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

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Interactions between your drugs

Moderate

psyllium lactulose

Applies to: calcium carbonate / psyllium and lactulose

GENERALLY AVOID: In the treatment of portal-systemic encephalopathy, the loose stools produced by concomitant use of other laxatives may falsely suggest that adequate lactulose dosage has been achieved.

MANAGEMENT: The use of other laxatives should generally be avoided when lactulose is prescribed for portal-systemic encephalopathy, especially during the initial phase of therapy.

References (2)
  1. (2012) "Product Information. Enulose (lactulose)." United Research Laboratories/Mutual Pharmaceutical Company
  2. (2019) "Product Information. Generlac (lactulose)." Morton Grove Pharmaceuticals Inc
Minor

calcium carbonate lactulose

Applies to: calcium carbonate / psyllium and lactulose

Preliminary data from studies in humans and rats suggest that nonabsorbable antacids given concurrently with lactulose may inhibit the reduction in colonic pH induced by lactulose. Theoretically, this may reduce the effectiveness of lactulose in the treatment of portal-systemic encephalopathy, which requires an acidic environment in the colon to promote extraction of ammonia from the blood as well as retention/elimination of ammonia as the ammonium ion. However, the clinical relevance of this interaction has not been fully elucidated.

References (2)
  1. (2002) "Product Information. Chronulac (lactulose)." Hoechst Marion Roussel
  2. (2002) "Product Information. Cephulac (lactulose)." Hoechst Marion Roussel

Drug and food interactions

Moderate

calcium carbonate food

Applies to: calcium carbonate / psyllium

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
Moderate

psyllium food

Applies to: calcium carbonate / psyllium

ADJUST DOSING INTERVAL: Bulk-forming laxatives such as guar gum, psyllium, polycarbophil, or methylcellulose may affect the bioavailability of concomitantly administered substances due to their effect on the rate of gastrointestinal transit and gastric emptying.

MANAGEMENT: In general, oral medications should be administered at least 2 hours before or 2 hours after dosing of the bulk-forming laxative.

References (1)
  1. (2001) "Product Information. Metamucil (psyllium)." Procter and Gamble Pharmaceuticals

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.

See also

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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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