Interactions between Ferotrin and Patiromer
1 drug interaction and 6 additional warnings found for the following 2 drugs:
- Ferotrin (multivitamin with iron)
- patiromer
Drug interactions
Moderate drug interactions
Moderate:
multivitamins with iron patiromer
Applies to: Ferotrin (multivitamin with iron) and patiromer
Adjust dosing interval
Simultaneous administration of cation-donating preparations may reduce the potassium exchange capability of cation-exchange resins due to binding of the cation to the resin.
Management
Patients should consider separating the times of administration of the cation-exchange resin and any cation-donating preparation (e.g., mineral supplements; antacids; products containing antacids such as didanosine buffered tablets or pediatric oral solution) by several hours if possible.
References (2)
- (2001) "Product Information. Kayexalate (sodium polystyrene sulfonate)." Sanofi Winthrop Pharmaceuticals
- (2002) "Product Information. Resonium Calcium (calcium polystyrene sulfonate)." Sanofi-Synthelabo Canada Inc
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
multivitamins with iron Food/Lifestyle
Applies to: Ferotrin (multivitamin with iron)
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)
- "Product Information. Feosol (ferrous sulfate)." SmithKline Beecham
- (2021) "Product Information. Accrufer (ferric maltol)." Shield Therapeutics
Moderate:
patiromer Food/Lifestyle
Applies to: patiromer
Adjust dosing interval
Patiromer can bind to some orally administered drugs, which may decrease their gastrointestinal absorption and reduce their effectiveness. According to the manufacturer, out of 28 drugs that were tested in in vitro binding studies, 14 did not show an interaction with patiromer (acetylsalicylic acid, allopurinol, amoxicillin, apixaban, atorvastatin, cephalexin, digoxin, glipizide, lisinopril, phenytoin, riboflavin, rivaroxaban, spironolactone, and valsartan). Twelve of the 14 drugs that did show an in vitro interaction were subsequently tested in in vivo studies with healthy volunteers, which revealed no changes in systemic exposure when coadministered with patiromer (amlodipine, cinacalcet, clopidogrel, furosemide, lithium, metoprolol, trimethoprim, verapamil, and warfarin). Patiromer was found to decrease systemic exposure of coadministered ciprofloxacin, levothyroxine, and metformin. However, no significant interaction occurred when patiromer and these drugs were dosed 3 hours apart.
Management
Patiromer should be administered with food at least 3 hours before or 3 hours after other oral medications. Alternatives to patiromer or the other medications should be considered if adequate dosing separation is not possible. Otherwise, clinical response and/or blood levels should be monitored where possible.
References (1)
- (2015) "Product Information. Veltassa (patiromer)." Relypsa, Inc.
Disease interactions
4 potential interactions Applies to: 4 conditions, including Constipation, Diarrhea, Magnesium Imbalance, and Gastrointestinal Obstruction.
Constipation
Major:
patiromer
Patiromer has a major potential interaction with Constipation.
The use of patiromer should be avoided in patients with severe constipation, bowel obstruction or impaction, including abnormal post-operative bowel motility disorders, as this agent may be ineffective and may worsen gastrointestinal conditions. Therapy with patiromer should be administered cautiously in patients with a history of bowel obstruction or major gastrointestinal surgery, severe gastrointestinal disorders, or swallowing disorders.
Diarrhea
Moderate:
patiromer
Patiromer has a moderate potential interaction with Diarrhea.
Patiromer binds to magnesium in the colon, which can lead to hypomagnesemia. It is recommended to monitor serum magnesium concentrations during therapy. Therapy with patiromer should be administered cautiously in patients with or predisposed to magnesium deficiency. Consider magnesium supplementation in patients who develop low serum magnesium levels.
Gastrointestinal Obstruction
Major:
patiromer
Patiromer has a major potential interaction with Gastrointestinal Obstruction.
The use of patiromer should be avoided in patients with severe constipation, bowel obstruction or impaction, including abnormal post-operative bowel motility disorders, as this agent may be ineffective and may worsen gastrointestinal conditions. Therapy with patiromer should be administered cautiously in patients with a history of bowel obstruction or major gastrointestinal surgery, severe gastrointestinal disorders, or swallowing disorders.
Magnesium Imbalance
Moderate:
patiromer
Patiromer has a moderate potential interaction with Magnesium Imbalance.
Patiromer binds to magnesium in the colon, which can lead to hypomagnesemia. It is recommended to monitor serum magnesium concentrations during therapy. Therapy with patiromer should be administered cautiously in patients with or predisposed to magnesium deficiency. Consider magnesium supplementation in patients who develop low serum magnesium levels.
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Ferotrin
A total of 106 drugs are known to interact with Ferotrin.
- Ferotrin is in the following drug classes: iron products, vitamin and mineral combinations.
- Ferotrin is used to treat the following conditions:
patiromer
A total of 165 drugs are known to interact with patiromer.
- Patiromer is in the drug class cation exchange resins.
- Patiromer is used to treat Hyperkalemia.
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
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.