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Can you take Caltrate 600+D with Colesevelam?

1 drug interaction and 26 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

ergocalciferol colesevelam

Applies to: Caltrate 600+D (calcium / vitamin d) and colesevelam

Colesevelam may interfere with the absorption of certain vitamins such as A, D, E and K. Therefore, it is recommended that you take ergocalciferol at least 4 hours before colesevelam to minimize the risk of interaction. Talk to your doctor or pharmacist if you have questions on how to take these or other medications you are prescribed. 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

Moderate food/lifestyle interactions

Moderate:

calcium carbonate Food/Lifestyle

Applies to: Caltrate 600+D (calcium / vitamin d)

Calcium absorption may be increased by taking it with food. However, foods high in oxalic acid (spinach or rhubarb), or phytic acid (bran and whole grains) may decrease calcium absorption. Calcium may be taken with food to increase absorption. Consider spacing calcium administration for at least 2 hours before or after consuming foods high in oxalic acid or phytic acid. Talk to your doctor 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.

Moderate:

ergocalciferol Food/Lifestyle

Applies to: Caltrate 600+D (calcium / vitamin d)

Treatment with ergocalciferol may require you to adjust your dietary intake of foods which contain natural or added calcium, phosphate (organic and inorganic), and vitamin D or grapefruit. Ingesting too much vitamin D or having elevated calcium and/or phosphorus levels in the blood and urine can lead to toxic effects, such as having an irregular heart rhythm, seizures, kidney stones, and eventual calcification of your blood vessels, cornea and/or the soft tissues in your body. Consumption of grapefruit and grapefruit juice may also alter the blood levels and effects of ergocalciferol. Your doctor will monitor the levels of calcium and phosphorus in your blood during treatment with ergocalciferol. Please speak with your healthcare team to determine if you require a specialized diet, particularly if you have reduced kidney function, and to discuss any other questions or concerns you have. You may require additional monitoring or a dose adjustment of ergocalciferol if your diet changes. Fortified foods will state on their labeling how much calcium, phosphate, and/or vitamin D has been added. The National Institutes of Health, Office of Dietary Supplements also provides information on which foods contain calcium, phosphorus, and vitamin D. You should avoid abrupt changes in your dietary calcium intake and seek medical attention if you experience early symptoms of vitamin D intoxication such as weakness, fatigue, headache, drowsiness, vertigo, ringing in the ears, loss of appetite, nausea, vomiting, constipation, dry mouth, metallic taste, muscle pain, bone pain, muscle incoordination, and low muscle tone. Late symptoms may include frequent urination, excessive thirst, weight loss, conjunctivitis ("pink eye"), light sensitivity, runny nose, itching, increased body temperature, and irregular heart rhythm. 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

24 potential interactions Applies to: 19 conditions, including Vitamin D Deficiency, Arrhythmia, Diabetes, Type 1, Gastroparesis, and Tachyarrhythmia.

Achlorhydria

Major:

Caltrate 600+D

The calcium carbonate in Caltrate 600+D has a major potential interaction with Achlorhydria.

Calcium is absorbed from the intestinal tract by active transport and passive diffusion. Malabsorption syndromes (celiac disease, GI resection), deficiency of vitamin D, parathyroid hormone, or calcitonin, or an alkaline gastric pH (achlorhydria, carbonate or phosphate salts) can decrease the absorption of oral formulations of calcium. Calcium is available in oral and parenteral formulations.

Arrhythmia

Major:

Caltrate 600+D

The calcium carbonate in Caltrate 600+D has a major potential interaction with Arrhythmia.

Calcium is involved in cardiac muscle contraction and electrical impulse conduction. Therapy with calcium salt formulations (particularly IV) should be administered cautiously to patients with cardiac disease. Patients receiving cardiac glycosides and concomitant IV calcium may experience arrhythmias. Therapy with IV calcium should be administered slowly and at reduced dosages in patients with cardiac disease.

Moderate:

Caltrate 600+D

The ergocalciferol in Caltrate 600+D has a moderate potential interaction with Arrhythmia.

Vitamin D analogs function to increase serum calcium concentrations and can exacerbate arrhythmias, particularly in patients receiving cardiac glycosides. Therapy with vitamin D analogs should be administered cautiously in patients with or predisposed to cardiac arrhythmias. Clinical monitoring of serum electrolyte concentrations and cardiac function is recommended.

Biliary Obstruction

Moderate:

Caltrate 600+D

The ergocalciferol in Caltrate 600+D has a moderate potential interaction with Biliary Obstruction.

Vitamin D analogs are fat soluble and oral formulations require bile for adequate intestinal absorption. Hepatic and/or biliary dysfunction decrease the absorption of vitamin D analogs. Metabolites of vitamin D analogs are primarily excreted in bile and feces. Ergocalciferol, cholecalciferol, and dihydrotachysterol undergo hepatic hydroxylation during metabolic activation. Hepatic impairment can alter the metabolic and therapeutic activity of certain vitamin D analogs. Alternative vitamin D analogs such as calcitriol (active form) may be considered in patients with compromised hepatic function.

Diabetes, Type 1

Major:

colesevelam

Colesevelam has a major potential interaction with Diabetes, Type 1.

Colesevelam should not be used for glycemic control in type 1 diabetes or for treating diabetic ketoacidosis.

Diabetic Ketoacidosis

Major:

colesevelam

Colesevelam has a major potential interaction with Diabetic Ketoacidosis.

Colesevelam should not be used for glycemic control in type 1 diabetes or for treating diabetic ketoacidosis.

Dysphagia

Major:

colesevelam

Colesevelam has a major potential interaction with Dysphagia.

The manufacturer considers colesevelam contraindicated in patients with a history of bowel obstruction. Because of its constipating effects, colesevelam is not recommended in patients with gastroparesis, other gastrointestinal motility disorders, and in those who have had major gastrointestinal tract surgery and who may be at risk for bowel obstruction. Because of the tablet size, colesevelam tablets can cause dysphagia or esophageal obstruction and should be used with caution in patients with dysphagia or swallowing disorders.

Gastrointestinal Obstruction

Major:

colesevelam

Colesevelam has a major potential interaction with Gastrointestinal Obstruction.

The manufacturer considers colesevelam contraindicated in patients with a history of bowel obstruction. Because of its constipating effects, colesevelam is not recommended in patients with gastroparesis, other gastrointestinal motility disorders, and in those who have had major gastrointestinal tract surgery and who may be at risk for bowel obstruction. Because of the tablet size, colesevelam tablets can cause dysphagia or esophageal obstruction and should be used with caution in patients with dysphagia or swallowing disorders.

Gastroparesis

Major:

colesevelam

Colesevelam has a major potential interaction with Gastroparesis.

The manufacturer considers colesevelam contraindicated in patients with a history of bowel obstruction. Because of its constipating effects, colesevelam is not recommended in patients with gastroparesis, other gastrointestinal motility disorders, and in those who have had major gastrointestinal tract surgery and who may be at risk for bowel obstruction. Because of the tablet size, colesevelam tablets can cause dysphagia or esophageal obstruction and should be used with caution in patients with dysphagia or swallowing disorders.

Hypercalcemia

Major:

Caltrate 600+D

The ergocalciferol in Caltrate 600+D has a major potential interaction with Hypercalcemia.

Vitamin D analogs such as calciferol and ergocalciferol should not be given to patients with hypercalcemia, malabsorption syndrome, or evidence of vitamin D toxicity.

Liver Disease

Moderate:

Caltrate 600+D

The ergocalciferol in Caltrate 600+D has a moderate potential interaction with Liver Disease.

Vitamin D analogs are fat soluble and oral formulations require bile for adequate intestinal absorption. Hepatic and/or biliary dysfunction decrease the absorption of vitamin D analogs. Metabolites of vitamin D analogs are primarily excreted in bile and feces. Ergocalciferol, cholecalciferol, and dihydrotachysterol undergo hepatic hydroxylation during metabolic activation. Hepatic impairment can alter the metabolic and therapeutic activity of certain vitamin D analogs. Alternative vitamin D analogs such as calcitriol (active form) may be considered in patients with compromised hepatic function.

Malabsorption Syndrome

Major:

Caltrate 600+D

The calcium carbonate in Caltrate 600+D has a major potential interaction with Malabsorption Syndrome.

Calcium is absorbed from the intestinal tract by active transport and passive diffusion. Malabsorption syndromes (celiac disease, GI resection), deficiency of vitamin D, parathyroid hormone, or calcitonin, or an alkaline gastric pH (achlorhydria, carbonate or phosphate salts) can decrease the absorption of oral formulations of calcium. Calcium is available in oral and parenteral formulations.

Major:

Caltrate 600+D

The ergocalciferol in Caltrate 600+D has a major potential interaction with Malabsorption Syndrome.

Vitamin D analogs such as calciferol and ergocalciferol should not be given to patients with hypercalcemia, malabsorption syndrome, or evidence of vitamin D toxicity.

Moderate:

colesevelam

Colesevelam has a moderate potential interaction with Malabsorption Syndrome.

Bile acid sequestrants, including colesevelam may decrease the absorption of fat-soluble vitamins A, D, E, and K. Caution should be exercised when treating patients with a susceptibility to deficiencies of vitamin K (e.g., patients on warfarin, patients with malabsorption syndromes) or other fat-soluble vitamins. The manufacturer recommends to instruct patients taking colesevelam and oral vitamin supplementation to take their vitamins at least 4 hours prior to colesevelam.

Phenylketonuria

Moderate:

colesevelam

Colesevelam has a moderate potential interaction with Phenylketonuria.

Questran Light and LoCholest Light (brands of cholestyramine) contain 16.8 mg and 22.4 mg of phenylalanine, respectively, per each dose. Flavored Colestid (brand of colestipol) contains 18.2 mg of phenylalanine per each 7.5-gram dose. WELCHOL (brand name of colesevelam) for Oral Suspension contains 13.5 mg phenylalanine per 1.875 gram dose and 27 mg phenylalanine per 3.75 gram dose. The phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics). Regular Colestid, Questran and LoCholest do not contain phenylalanine.

Phosphate Imbalance

Major:

Caltrate 600+D

The calcium carbonate in Caltrate 600+D has a major potential interaction with Phosphate Imbalance.

Elevated serum concentrations of calcium and phosphate can exceed the solubility level and result in calcium- phosphate precipitates that deposit in vascular and renal systems as well as other soft tissues of the body. Therapy with calcium should be administered with extreme caution in patients with hyperphosphatemia (hypoparathyroidism or severe renal impairment). Administration of oral calcium acetate or calcium carbonate, in addition to providing calcium, complexes phosphates within the GI tract. These complexes are eliminated in the feces. Clinical monitoring of serum calcium and phosphate concentrations is necessary.

Moderate:

Caltrate 600+D

The ergocalciferol in Caltrate 600+D has a moderate potential interaction with Phosphate Imbalance.

Vitamin D analogs administered in the presence of hyperphosphatemia can result in precipitation of calcium-phosphate deposits within the vascular or renal systems or other soft tissue calcifications. A solubility product (Serum Calcium X Phosphate) should not exceed 70. Serum electrolyte concentrations should be corrected prior to vitamin D analog therapy and monitored during therapy.

Renal Dysfunction

Major:

Caltrate 600+D

The calcium carbonate in Caltrate 600+D has a major potential interaction with Renal Dysfunction.

Absorption of oral calcium formulations may be altered and elimination of calcium by the kidney decreased with renal impairment. Hyperphosphatemia occurs during renal failure. Calcium acetate or calcium carbonate, in addition to providing calcium, complexes phosphates within the GI tract. Calcium carbonate can partially correct metabolic acidosis associated with chronic renal failure. Clinical monitoring of renal function and serum calcium and phosphate concentrations is necessary.

Moderate:

Caltrate 600+D

The ergocalciferol in Caltrate 600+D has a moderate potential interaction with Renal Dysfunction.

Ergocalciferol and cholecalciferol undergo renal biotransformation during metabolic activation. Renal impairment can alter metabolic and therapeutic activity of certain vitamin D analogs. Alternative vitamin D analogs such as dihydrotachysterol (hepatic activation) and calcitriol (active form) may be considered in patients with compromised renal function.

Sarcoidosis

Major:

Caltrate 600+D

The calcium carbonate in Caltrate 600+D has a major potential interaction with Sarcoidosis.

Hypercalciuria, with or without hypercalcemia, may occasionally occur in patients with sarcoidosis. Elevated calcium levels may result from increased intestinal absorption of calcium, which is related to the extrarenal production of vitamin D by mononuclear phagocytes present within the sarcoid granuloma. Therapy with calcium salts should be administered cautiously and only if necessary in patients with sarcoidosis.

Tachyarrhythmia

Major:

Caltrate 600+D

The ergocalciferol in Caltrate 600+D has a major potential interaction with Tachyarrhythmia.

The amine ergot alkaloids, ergonovine and methylergonovine, can cause serious cardiovascular complications because of their vasospastic effects. Hypertension (more often with ergonovine) has been most commonly reported, particularly when administered IV undiluted or at an excessive rate or when used in conjunction with regional anesthesia or vasoconstrictors. Headaches, seizures, cerebrovascular accidents and death have been associated with the hypertensive episodes. Other, less common adverse effects include acute myocardial infarction, transient chest pains, thrombophlebitis, tachycardia and palpitations. Therapy with ergot alkaloids should generally be avoided, except under special circumstances, in patients with chronic hypertension, preeclampsia or eclampsia, cardiovascular disease, cerebrovascular disease, or peripheral vascular disease. Caution is advised when these agents are administered to patients with venoatrial shunts, mitral valve stenosis, or sepsis. Close monitoring of cardiovascular status is highly recommended during therapy.

Vitamin A Deficiency

Moderate:

colesevelam

Colesevelam has a moderate potential interaction with Vitamin A Deficiency.

Bile acid sequestrants, including colesevelam may decrease the absorption of fat-soluble vitamins A, D, E, and K. Caution should be exercised when treating patients with a susceptibility to deficiencies of vitamin K (e.g., patients on warfarin, patients with malabsorption syndromes) or other fat-soluble vitamins. The manufacturer recommends to instruct patients taking colesevelam and oral vitamin supplementation to take their vitamins at least 4 hours prior to colesevelam.

Vitamin D Deficiency

Moderate:

colesevelam

Colesevelam has a moderate potential interaction with Vitamin D Deficiency.

Bile acid sequestrants, including colesevelam may decrease the absorption of fat-soluble vitamins A, D, E, and K. Caution should be exercised when treating patients with a susceptibility to deficiencies of vitamin K (e.g., patients on warfarin, patients with malabsorption syndromes) or other fat-soluble vitamins. The manufacturer recommends to instruct patients taking colesevelam and oral vitamin supplementation to take their vitamins at least 4 hours prior to colesevelam.

Vitamin K Deficiency

Moderate:

colesevelam

Colesevelam has a moderate potential interaction with Vitamin K Deficiency.

Bile acid sequestrants, including colesevelam may decrease the absorption of fat-soluble vitamins A, D, E, and K. Caution should be exercised when treating patients with a susceptibility to deficiencies of vitamin K (e.g., patients on warfarin, patients with malabsorption syndromes) or other fat-soluble vitamins. The manufacturer recommends to instruct patients taking colesevelam and oral vitamin supplementation to take their vitamins at least 4 hours prior to colesevelam.

More resources

Caltrate 600+D

A total of 310 drugs are known to interact with Caltrate 600+D.

colesevelam

A total of 97 drugs are known to interact with colesevelam.

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.