Drug Interactions between DermacinRx PureFolix and st. john's wort
This report displays the potential drug interactions for the following 2 drugs:
- DermacinRx PureFolix (cholecalciferol/folic acid)
- st. john's wort
Interactions between your drugs
cholecalciferol St. John's wort
Applies to: DermacinRx PureFolix (cholecalciferol / folic acid) and st. john's wort
MONITOR: Coadministration with CYP450 inducers such as rifampin, isoniazid, barbiturates, and certain anticonvulsants may decrease the pharmacologic effects of vitamin D analogs. These agents are thought to induce the hepatic conversion of vitamin D to inactive metabolites and have been shown to reduce circulating levels of active vitamin D, sometimes accompanied by reduced serum calcium and increased parathyroid hormone levels. Patients on long-term anticonvulsant therapy have occasionally developed osteomalacia, presumably due to interference with vitamin D and calcium metabolism. There have also been isolated reports of patients who responded poorly to vitamin D supplements during treatment with phenytoin and/or primidone.
MANAGEMENT: Patients receiving vitamin D analogs with CYP450 inducers should be monitored for potentially reduced vitamin D effects. Dosage adjustments may be necessary.
References
- (2001) "Product Information. Rocaltrol (calcitriol)." Roche Laboratories
- (2001) "Product Information. Zemplar (paricalcitol)." Abbott Pharmaceutical
- (2004) "Product Information. Hectorol (doxercalciferol)." Genzyme Corporation
- (2004) "Product Information. One-Alpha (alfacalcidol)." Pharmel Inc
Drug and food interactions
folic acid food
Applies to: DermacinRx PureFolix (cholecalciferol / folic acid)
MONITOR: Ethanol may increase folic acid elimination and folic acid absorption is decreased in chronic alcoholics. Excessive alcohol consumption may lead to folate deficiency.
MANAGEMENT: Monitoring of patient response to folic acid supplementation if they also consume alcohol regularly may be recommended.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
- Agencia Española de Medicamentos y Productos Sanitarios Healthcare (2008) Centro de información online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html
- Cerner Multum, Inc (2015) "ANVISA Bulário Eletrônico."
- (2017) "Product Information. Folic Acid (folic acid)." Method Pharmaceuticals, LLC
St. John's wort food
Applies to: st. john's wort
GENERALLY AVOID: An isolated case report suggests that foods containing large amounts of tyramine may precipitate a hypertensive crisis in patients treated with St. John's wort. The mechanism of interaction is unknown, as St. John's wort is not thought to possess monoamine oxidase (MAO) inhibiting activity at concentrations achieved in vivo. The case patient was a 41-year-old man who had been taking St. John's wort for seven days prior to presentation at the emergency room with confusion and disorientation. The patient recalled last eating aged cheese and having a glass of red wine approximately 10 hours prior to admission. No other cause of delirium or hypertension could be identified. In addition, alcohol may potentiate some of the pharmacologic effects of St. John's wort. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.
MANAGEMENT: Until further information is available, patients treated with St. John's wort should consider avoiding consumption of protein foods in which aging or breakdown of protein is used to increase flavor. These foods include cheese (particularly strong, aged or processed cheeses), sour cream, wine (particularly red wine), champagne, beer, pickled herring, anchovies, caviar, shrimp paste, liver (particularly chicken liver), dry sausage, figs, raisins, bananas, avocados, chocolate, soy sauce, bean curd, yogurt, papaya products, meat tenderizers, fava beans, protein extracts, and dietary supplements. Caffeine may also precipitate hypertensive crisis so its intake should be minimized as well. Patients should also be advised to avoid or limit consumption of alcohol.
References
- Patel S, Robinson R, Burk M (2002) "Hypertensive crisis associated with St. John's Wort." Am J Med, 112, p. 507-8
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.
See also
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
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