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Interactions between Entacapone and Vitafol Strips

1 drug interaction and 5 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

multivitamins, prenatal entacapone

Applies to: Vitafol Strips (multivitamin, prenatal) and entacapone
Adjust dosing interval

The oral bioavailability of entacapone and iron salts may be decreased during concurrent administration. The proposed mechanism is chelation of iron by entacapone, forming an insoluble complex that is poorly absorbed from the gastrointestinal tract. Entacapone has been shown to be a chelator of iron. The impact of entacapone on the body's iron stores is unknown, but in clinical trials, a tendency towards decreasing serum iron concentrations was reported. In one controlled study, serum ferritin levels (a marker of iron deficiency and subclinical anemia) were not altered with entacapone compared to placebo, and there was no difference in frequency of anemia or decreased hemoglobin levels. However, slight decreases in hemoglobin, erythrocyte count, and hematocrit have been reported during entacapone treatment. After 6 months of entacapone therapy, a clinically significant decrease in hemoglobin has been observed in 1.5% of patients.

Management

Patients receiving entacapone concomitantly with iron-containing products should be advised to separate the times of administration by 2 to 3 hours.

References (1)
  1. (2001) "Product Information. Comtan (entacapone)." Novartis Pharmaceuticals

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

multivitamins, prenatal Food/Lifestyle

Applies to: Vitafol Strips (multivitamin, prenatal)
Adjust dosing interval

Concomitant use of some oral medications may reduce the bioavailability of orally administered iron, and vice versa. Food taken in conjunction with oral iron supplements may reduce the bioavailability of the iron. However, in many patients intolerable gastrointestinal side effects occur necessitating administration with food.

Management

Ideally, iron products should be taken on an empty stomach (i.e., at least 1 hour before or 2 hours after meals), but if this is not possible, administer with meals and monitor the patient more closely for a subtherapeutic effect. Some studies suggest administration of iron with ascorbic acid may enhance bioavailability. In addition, administration of oral iron products and some oral medications should be separated whenever the bioavailability of either agent may be decreased. Consult the product labeling for specific separation times and monitor clinical responses as appropriate.

References (2)
  1. "Product Information. Feosol (ferrous sulfate)." SmithKline Beecham
  2. (2021) "Product Information. Accrufer (ferric maltol)." Shield Therapeutics
Moderate:

entacapone Food/Lifestyle

Applies to: entacapone
Generally avoid

Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

Management

Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References (4)
  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka America Pharmaceutical, Inc.

Disease interactions

3 potential interactions Applies to: 3 conditions, including Hypotension, Psychosis, and Liver Disease.

Hypotension

Moderate:

entacapone

Entacapone has a moderate potential interaction with Hypotension.

Dopamine agonists may impair the systemic regulation of blood pressure, with resultant orthostatic hypotension at any time, but especially during dose escalation. Additionally, patients with Parkinson's disease may have an impaired capacity to respond to an orthostatic challenge. For these reasons, patients with Parkinson's disease (or restless legs syndrome) who are being treated with dopaminergic agonists typically require careful monitoring for signs/symptoms of orthostatic hypotension, especially during dose escalation, and should be advised of this risk.

Liver Disease

Moderate:

entacapone

Entacapone has a moderate potential interaction with Liver Disease.

Entacapone should be used with caution in patients with hepatic impairment, as the AUC and Cmax of the drug approximately doubled in patients with documented liver disease compared to patients with normal liver function.

Psychosis

Moderate:

entacapone

Entacapone has a moderate potential interaction with Psychosis.

Ordinarily, patients with major psychotic disorder should not be treated with dopaminergic antiparkinsonian agents, because of the risk of exacerbating psychosis. Hallucinations and psychotic-like behavior have been reported with dopaminergic medications. In addition, certain medications used to treat psychosis may exacerbate the symptoms of Parkinson's disease and may decrease the effectiveness of these drugs. The use of bromocriptine in patients with severe psychotic disorders is not recommended.

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More resources

entacapone

A total of 281 drugs are known to interact with entacapone.

Vitafol Strips

A total of 172 drugs are known to interact with Vitafol Strips.

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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