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Drug Interactions between Citracal Calcium Gummies and Flanax Antacid Liquid

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

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Interactions between your drugs

Moderate

aluminum hydroxide ergocalciferol

Applies to: Flanax Antacid Liquid (aluminum hydroxide / magnesium hydroxide / simethicone) and Citracal Calcium Gummies (calcium / vitamin d)

Consumer information for this interaction is not currently available.

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.

Moderate

magnesium hydroxide ergocalciferol

Applies to: Flanax Antacid Liquid (aluminum hydroxide / magnesium hydroxide / simethicone) and Citracal Calcium Gummies (calcium / vitamin d)

Using ergocalciferol together with magnesium hydroxide can lead to elevated magnesium blood levels, particularly in individuals with reduced kidney function. Symptoms of high magnesium levels may include nausea, vomiting, flushing, drowsiness, dizziness, confusion, muscle weakness, reduced reflexes, low blood pressure, slow heart rate, and impaired breathing. You should seek medical attention if you experience these symptoms. If you are on dialysis and treated with ergocalciferol or other vitamin D medications, you should generally avoid taking products that contain magnesium without first talking to your doctor, as high levels of magnesium over time can lead to bone problems. 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.

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Drug and food interactions

Major

aluminum hydroxide food

Applies to: Flanax Antacid Liquid (aluminum hydroxide / magnesium hydroxide / simethicone)

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.

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Moderate

calcium carbonate food

Applies to: Citracal Calcium Gummies (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.

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Moderate

ergocalciferol food

Applies to: Citracal Calcium Gummies (calcium / vitamin d)

Consumer information for this interaction is not currently available.

MONITOR: Additive effects and possible toxicity (e.g., hypercalcemia, hypercalciuria, and/or hyperphosphatemia) may occur when patients using vitamin D and/or vitamin D analogs ingest a diet high in vitamin D, calcium, and/or phosphorus. The biologically active forms of vitamin D stimulate intestinal absorption of calcium and phosphorus. This may be helpful in patients with hypocalcemia and/or hypophosphatemia. However, sudden increases in calcium or phosphorus consumption due to dietary changes could precipitate hypercalcemia and/or hyperphosphatemia. Patients with certain disease states, such as impaired renal function, may be more susceptible to toxic side effects like ectopic calcification. On the other hand, if dietary calcium is inadequate for the body's needs, the active form of vitamin D will stimulate osteoclasts to pull calcium from the bones. This may be detrimental in a patient with reduced bone density.

MANAGEMENT: Given the narrow therapeutic index of vitamin D and vitamin D analogs, the amounts of calcium, phosphorus, and vitamin D present in the patient's diet may need to be taken into consideration. Specific dietary guidance should be discussed with the patient and regular lab work should be monitored as indicated. Calcium, phosphorus, and vitamin D levels should be kept within the desired ranges, which may differ depending on the patient's condition. Patients should also be counseled on the signs and symptoms of hypervitaminosis D, hypercalcemia, and/or hyperphosphatemia.

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.