Drug Interactions between cholecalciferol / iron polysaccharide and trientine

Take trientine on an empty stomach 1 hour before or 2 hours after a meal and at least one hour apart from any other food, drug, or milk. You may experience reduced absorption of trientine in the presence of food or milk. The capsules should be swallowed whole with water and should not be opened or chewed.

Treatment with cholecalciferol may require you to adjust your dietary intake of foods which contain natural or added calcium, phosphate (organic and inorganic), and vitamin D. 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. Your doctor will monitor the levels of calcium and phosphorus in your blood during treatment with cholecalciferol. 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 cholecalciferol 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.

Food may reduce the absorption and blood levels of iron polysaccharide. In addition, some oral medications can also interfere with iron polysaccharide absorption into the bloodstream, which may make the medication less effective in treating your condition. Likewise, iron polysaccharide may interfere with the absorption of other orally administered medications. You should take iron polysaccharide on an empty stomach at least one hour before or two hours after a meal. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Talk to your doctor or pharmacist if you have questions about how to take this 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.

Mineral supplements or mineral-containing medications such as multivitamin with minerals can bind to trientine in the gastrointestinal tract, which may reduce the absorption of both trientine and the mineral. It is best to avoid taking these medications together when possible. However, if you must take both, you should try to separate the times of administration by at least two hours. Talk to your doctor if you have any questions or concerns. 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.