Drug Interactions between Iron Sulfate and peanut allergen powder

ADJUST DOSING INTERVAL: Coadministration of peanut allergen extract with alcohol may potentiate the risk of allergic reactions, including anaphylaxis. According to some studies, alcohol is an augmenting factor influencing immunological mechanisms that can induce more severe allergic reactions and is involved in up to 15% of cases of anaphylactic reactions. Proposed mechanisms include an increase in allergen absorption from altered permeability of the intestinal epithelial barrier, enhancing mast cell and basophil activation, and an increase in serum IgE concentrations. In addition, according to product labeling, administration of peanut allergen extract during a fasting state may potentiate the risk of allergic reactions, including anaphylaxis. The exact mechanism has not been elucidated.

MANAGEMENT: To minimize the risk of allergic reactions, including anaphylaxis, some authorities recommend alcohol not be consumed for 2 hours before, or 2 hours after taking peanut allergen extract. If alcohol cannot be avoided, withholding or decreasing peanut allergen dosage should be considered. Peanut allergen extract should also be administered with an evening meal and not within 2 hours of bedtime.

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.