Drug Interactions between dextromethorphan / quinidine and dihydroxyaluminum sodium carbonate

Citrate, or citric acid, can increase the absorption of dihydroxyaluminum sodium carbonate. 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 dihydroxyaluminum sodium carbonate 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 dihydroxyaluminum sodium carbonate. 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 dihydroxyaluminum sodium carbonate 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 dihydroxyaluminum sodium carbonate is taken during enteral nutrition therapy (tube feeding), the tube may get clogged. Therefore, dihydroxyaluminum sodium carbonate 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.

Do not consume grapefruit or grapefruit juice during treatment with quiNIDine unless specifically directed otherwise by your doctor. Grapefruit and grapefruit juice can interact with quiNIDine and increase the levels of quiNIDine in your body. If you are already consuming grapefruit products, do not increase or decrease the amount of these products in your diet without first talking to your doctor.

Alcohol can increase the nervous system side effects of dextromethorphan such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with dextromethorphan. Do not use more than the recommended dose of dextromethorphan, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.