Drug Interactions between Citracal Regular and sodium polystyrene sulfonate

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.

Foods high in potassium such as orange juice and other fruit juices may reduce the effectiveness of sodium polystyrene sulfonate in treating your condition. Do not mix sodium polystyrene sulfonate in fruit juice or drink fruit juice with it. Also, sodium polystyrene sulfonate may interfere with the absorption of other medications that you take by mouth, including both prescription medications such as antibiotics, blood pressure/heart medications and blood thinners, and over-the-counter products such as antacids and laxatives. This can lead to lower blood levels and reduced effects if you take them too closely together with sodium polystyrene sulfonate. It is recommended that you separate the dosing of sodium polystyrene sulfonate from other oral medications by at least 3 hours whenever possible. This interval should be increased to 6 hours if you have gastroparesis or other conditions that cause delayed emptying of food from the stomach into the intestine. Talk to your doctor or pharmacist 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.

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. 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 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.

Sodium polystyrene sulfonate can bind to calcium, iron, magnesium, and other minerals in the gastrointestinal tract. This may inactivate both sodium polystyrene sulfonate and the mineral it binds to and reduce the effectiveness of both medications. To avoid or minimize the interaction, the dosing times of sodium polystyrene sulfonate and multivitamin with minerals should be separated by several hours. Talk to your doctor if you have any questions or concerns, or if you have trouble separating the dosing times. 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.