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Drug Interactions between Cytotec and Mi-Acid Double Strength

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

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Interactions between your drugs

Moderate

miSOPROStol magnesium hydroxide

Applies to: Cytotec (misoprostol) and Mi-Acid Double Strength (calcium carbonate / magnesium hydroxide)

GENERALLY AVOID: Magnesium-containing antacids can exacerbate misoprostol-induced diarrhea. Additionally, antacids in general can reduce the bioavailability of misoprostol acid (the active metabolite of misoprostol), although clinical trials of misoprostol conducted with concomitant antacid use suggest that this effect is not clinically important.

MANAGEMENT: Use of misoprostol in combination with magnesium-containing antacids is not recommended. If an antacid is needed, one that contains aluminum or calcium should be prescribed.

References

  1. Karim A, Rozek LF, Smith ME, Kowalski KG "Effects of food and antacid on oral absorption of misoprostol, a synthetic prostaglandin E1 analog." J Clin Pharmacol 29 (1989): 439-43
  2. "Product Information. Arthrotec (diclofenac-misoprostol)." Searle PROD (2001):

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Minor

miSOPROStol calcium carbonate

Applies to: Cytotec (misoprostol) and Mi-Acid Double Strength (calcium carbonate / magnesium hydroxide)

Concomitant administration of antacids can reduce the bioavailability of misoprostol acid, the active metabolite of misoprostol. The mechanism of interaction is unknown. In twelve study subjects, coadministration of misoprostol with antacid reduced the bioavailability of misoprostol acid by 16% relative to fasting. Clinical trials of misoprostol conducted with concomitant antacid use suggest that this effect is not clinically important.

References

  1. Karim A, Rozek LF, Smith ME, Kowalski KG "Effects of food and antacid on oral absorption of misoprostol, a synthetic prostaglandin E1 analog." J Clin Pharmacol 29 (1989): 439-43
  2. "Product Information. Arthrotec (diclofenac-misoprostol)." Searle PROD (2001):

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Drug and food interactions

Moderate

calcium carbonate food

Applies to: Mi-Acid Double Strength (calcium carbonate / magnesium hydroxide)

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

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Canadian Pharmacists Association "e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink" (2006):
  3. Cerner Multum, Inc. "Australian Product Information." O 0
  4. Agencia Española de Medicamentos y Productos Sanitarios Healthcare "Centro de información online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html" (2008):
  5. Mangels AR "Bone nutrients for vegetarians." Am J Clin Nutr 100 (2014): epub
  6. Davies NT "Anti-nutrient factors affecting mineral utilization." Proc Nutr Soc 38 (1979): 121-8
View all 6 references

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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.

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