Drug Interactions between Ferrex 150 Plus and Hemangeol
This report displays the potential drug interactions for the following 2 drugs:
- Ferrex 150 Plus (ascorbic acid/iron polysaccharide)
- Hemangeol (propranolol)
Interactions between your drugs
propranolol ascorbic acid
Applies to: Hemangeol (propranolol) and Ferrex 150 Plus (ascorbic acid/iron polysaccharide)
Limited data suggest that ascorbic acid may decrease the oral bioavailability of propranolol by possibly interfering with its absorption from the gastrointestinal tract. In 5 healthy subjects, pretreatment with a 2 gram dose of ascorbic acid 30 minutes before an 80 mg dose of propranolol decreased the peak plasma concentration (Cmax) and 24-hour area under the concentration-time curve (AUC) of propranolol by 28% and 37%, respectively, compared to when propranolol was administered alone. The time to reach maximum propranolol concentration (Tmax) was increased from 1.9 to 2.7 hours, and the total amount of drug (including metabolites) recovered in urine was significantly diminished. Although the heart rate decreased less during coadministration with ascorbic acid, the clinical significance is considered minor.
References
- Gonzalez JP, Valdivieso A, Calvo R, Rodriquezsasiain JM, Jimenez R, Aguirre C, Dusouich P (1995) "Influence of vitamin c on the absorption and first pass metabolism of propranolol." Eur J Clin Pharmacol, 48, p. 295-7
Drug and food interactions
propranolol food
Applies to: Hemangeol (propranolol)
ADJUST DOSING INTERVAL: The bioavailability of propranolol may be enhanced by food.
MANAGEMENT: Patients may be instructed to take propranolol at the same time each day, preferably with or immediately following meals.
References
- Olanoff LS, Walle T, Cowart TD, et al. (1986) "Food effects on propranolol systemic and oral clearance: support for a blood flow hypothesis." Clin Pharmacol Ther, 40, p. 408-14
- Byrne AJ, McNeil JJ, Harrison PM, Louis W, Tonkin AM, McLean AJ (1984) "Stable oral availability of sustained release propranolol when co-administered with hydralazine or food: evidence implicating substrate delivery rate as a determinant of presystemic drug interactions." Br J Clin Pharmacol, 17, s45-50
iron polysaccharide food
Applies to: Ferrex 150 Plus (ascorbic acid/iron polysaccharide)
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
- "Product Information. Feosol (ferrous sulfate)." SmithKline Beecham
- (2021) "Product Information. Accrufer (ferric maltol)." Shield Therapeutics
propranolol food
Applies to: Hemangeol (propranolol)
ADJUST DOSING INTERVAL: Concurrent administration with calcium salts may decrease the oral bioavailability of atenolol and possibly other beta-blockers. The exact mechanism of interaction is unknown. In six healthy subjects, calcium 500 mg (as lactate, carbonate, and gluconate) reduced the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of atenolol (100 mg) by 51% and 32%, respectively. The elimination half-life increased by 44%. Twelve hours after the combination, beta-blocking activity (as indicated by inhibition of exercise tachycardia) was reduced compared to that with atenolol alone. However, during a 4-week treatment in six hypertensive patients, there was no difference in blood pressure values between treatments. The investigators suggest that prolongation of the elimination half-life induced by calcium coadministration may have led to atenolol cumulation during long-term dosing, which compensated for the reduced bioavailability.
MANAGEMENT: It may help to separate the administration times of beta-blockers and calcium products by at least 2 hours. Patients should be monitored for potentially diminished beta-blocking effects following the addition of calcium therapy.
References
- Kirch W, Schafer-Korting M, Axthelm T, Kohler H, Mutschler E (1981) "Interaction of atenolol with furosemide and calcium and aluminum salts." Clin Pharmacol Ther, 30, p. 429-35
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
Report options
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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