Drug Interactions between FE C Tab Plus and lanthanum carbonate

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.

GENERALLY AVOID: Lanthanum carbonate should be administered with food for therapeutic efficacy. However, it is insoluble in water (<0.01 mg/mL at pH 7.5) and therefore cannot be dissolved in liquid for administration through an enteral feeding tube, because it may result in blockage of the tube.

MANAGEMENT: Administration of lanthanum carbonate with enteral feedings is not recommended. Alternative medications such as calcium carbonate suspension should be considered.

The use of lanthanum carbonate is contraindicated in patients with bowel obstruction, including ileus and fecal impaction.

Serious cases of gastrointestinal obstruction and perforation have been reported in patients taking lanthanum, some requiring surgery and hospitalization. Risk factors identified from post marketing reports include altered gastrointestinal anatomy (diverticular disease, peritonitis, history of GI surgery, ulceration or cancer), hypomotility disorders, and some concomitant medications as calcium channel blockers. However, some cases have also been reported in patients with no history of gastrointestinal disease. Lanthanum should be used cautiously in patients with gastrointestinal disease.

Serious cases of gastrointestinal obstruction and perforation have been reported in patients taking lanthanum, some requiring surgery and hospitalization. Risk factors identified from post marketing reports include altered gastrointestinal anatomy (diverticular disease, peritonitis, history of GI surgery, ulceration or cancer), hypomotility disorders, and some concomitant medications as calcium channel blockers. However, some cases have also been reported in patients with no history of gastrointestinal disease. Lanthanum should be used cautiously in patients with gastrointestinal disease.

Serious cases of gastrointestinal obstruction and perforation have been reported in patients taking lanthanum, some requiring surgery and hospitalization. Risk factors identified from post marketing reports include altered gastrointestinal anatomy (diverticular disease, peritonitis, history of GI surgery, ulceration or cancer), hypomotility disorders, and some concomitant medications as calcium channel blockers. However, some cases have also been reported in patients with no history of gastrointestinal disease. Lanthanum should be used cautiously in patients with gastrointestinal disease.

Serious cases of gastrointestinal obstruction and perforation have been reported in patients taking lanthanum, some requiring surgery and hospitalization. Risk factors identified from post marketing reports include altered gastrointestinal anatomy (diverticular disease, peritonitis, history of GI surgery, ulceration or cancer), hypomotility disorders, and some concomitant medications as calcium channel blockers. However, some cases have also been reported in patients with no history of gastrointestinal disease. Lanthanum should be used cautiously in patients with gastrointestinal disease.