Skip to main content

Drug Interactions between Magnaprin and rifampin

This report displays the potential drug interactions for the following 2 drugs:

Edit list (add/remove drugs)

Interactions between your drugs

Moderate

rifAMPin calcium carbonate

Applies to: rifampin and Magnaprin (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide)

ADJUST DOSING INTERVAL: Limited data suggest that some antacids may decrease the oral bioavailability of rifampin. The mechanisms include decreased dissolution of rifampin in the presence of increased gastric pH and/or aluminum chelation with rifampin. The clinical significance has not been established.

MANAGEMENT: Rifampin should be administered at least 1 hour before antacids. Monitoring for altered therapeutic effect is advisable.

References

  1. (2001) "Product Information. Rifadin (rifampin)." Hoechst Marion Roussel

Switch to consumer interaction data

Moderate

aspirin calcium carbonate

Applies to: Magnaprin (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide) and Magnaprin (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide)

MONITOR: Chronic administration of antacids may reduce serum salicylate concentrations in patients receiving large doses of aspirin or other salicylates. The mechanism involves reduction in salicylate renal tubular reabsorption due to urinary alkalinization by antacids, resulting in increased renal salicylate clearance. In three children treated with large doses of aspirin for rheumatic fever, serum salicylate levels declined 30% to 70% during coadministration with a magnesium and aluminum hydroxide antacid. Other studies have found similar, albeit less dramatic results. Antacids reportedly have no effect on the oral bioavailability of aspirin in healthy adults. However, administration of antacids containing either aluminum and magnesium hydroxide or calcium carbonate two hours before aspirin dosing led to reduced absorption of aspirin in uremic patients.

MANAGEMENT: Patients treated chronically with antacids (or oral medications that contain antacids such as didanosine buffered tablets or pediatric oral solution) and large doses of salicylates (i.e. 3 g/day or more) should be monitored for potentially diminished or inadequate analgesic and anti-inflammatory effects, and the salicylate dosage adjusted if necessary.

References

  1. D'Arcy PF, McElnay JC (1987) "Drug-antacid interactions: assessment of clinical importance." Drug Intell Clin Pharm, 21, p. 607-17
  2. Gaspari F, Vigano G, Locatelli M, Remuzzi G (1988) "Influence of antacid administrations on aspirin absorption in patients with chronic renal failure on maintenance hemodialysis." Am J Kidney Dis, 11, p. 338-42
  3. Furst DE (1988) "Clinically important interactions of nonsteroidal antiinflammatory drugs with other medications." J Rheumatol Suppl, 17, p. 58-62
  4. Miners JO (1989) "Drug interactions involving aspirin (acetylsalicylic acid) and salicylic acid." Clin Pharmacokinet, 17, p. 327-44
  5. Levy G, Lampman T, Kamath BL, Garrettson LK (1975) "Decreased serum salicylate concentrations in children with rheumatic fever treated with antacid." N Engl J Med, 293, p. 323-5
  6. Shastri RA (1985) "Effect of antacids on salicylate kinetics." Int J Clin Pharmacol Ther Toxicol, 23, p. 480-4
  7. Covington TR, eds., Lawson LC, Young LL (1993) "Handbook of Nonprescription Drugs." Washington, DC: American Pharmaceutical Association
  8. Brouwers JRBJ, Desmet PAGM (1994) "Pharmacokinetic-pharmacodynamic drug interactions with nonsteroidal anti-inflammatory drugs." Clin Pharmacokinet, 27, p. 462-85
  9. (2023) "Product Information. Diflunisal (diflunisal)." Chartwell RX, LLC.
View all 9 references

Switch to consumer interaction data

Moderate

rifAMPin aluminum hydroxide

Applies to: rifampin and Magnaprin (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide)

ADJUST DOSING INTERVAL: Limited data suggest that some antacids may decrease the oral bioavailability of rifampin. The mechanisms include decreased dissolution of rifampin in the presence of increased gastric pH and/or aluminum chelation with rifampin. The clinical significance has not been established.

MANAGEMENT: Rifampin should be administered at least 1 hour before antacids. Monitoring for altered therapeutic effect is advisable.

References

  1. (2001) "Product Information. Rifadin (rifampin)." Hoechst Marion Roussel

Switch to consumer interaction data

Moderate

aspirin aluminum hydroxide

Applies to: Magnaprin (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide) and Magnaprin (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide)

MONITOR: Chronic administration of antacids may reduce serum salicylate concentrations in patients receiving large doses of aspirin or other salicylates. The mechanism involves reduction in salicylate renal tubular reabsorption due to urinary alkalinization by antacids, resulting in increased renal salicylate clearance. In three children treated with large doses of aspirin for rheumatic fever, serum salicylate levels declined 30% to 70% during coadministration with a magnesium and aluminum hydroxide antacid. Other studies have found similar, albeit less dramatic results. Antacids reportedly have no effect on the oral bioavailability of aspirin in healthy adults. However, administration of antacids containing either aluminum and magnesium hydroxide or calcium carbonate two hours before aspirin dosing led to reduced absorption of aspirin in uremic patients.

MANAGEMENT: Patients treated chronically with antacids (or oral medications that contain antacids such as didanosine buffered tablets or pediatric oral solution) and large doses of salicylates (i.e. 3 g/day or more) should be monitored for potentially diminished or inadequate analgesic and anti-inflammatory effects, and the salicylate dosage adjusted if necessary.

References

  1. D'Arcy PF, McElnay JC (1987) "Drug-antacid interactions: assessment of clinical importance." Drug Intell Clin Pharm, 21, p. 607-17
  2. Gaspari F, Vigano G, Locatelli M, Remuzzi G (1988) "Influence of antacid administrations on aspirin absorption in patients with chronic renal failure on maintenance hemodialysis." Am J Kidney Dis, 11, p. 338-42
  3. Furst DE (1988) "Clinically important interactions of nonsteroidal antiinflammatory drugs with other medications." J Rheumatol Suppl, 17, p. 58-62
  4. Miners JO (1989) "Drug interactions involving aspirin (acetylsalicylic acid) and salicylic acid." Clin Pharmacokinet, 17, p. 327-44
  5. Levy G, Lampman T, Kamath BL, Garrettson LK (1975) "Decreased serum salicylate concentrations in children with rheumatic fever treated with antacid." N Engl J Med, 293, p. 323-5
  6. Shastri RA (1985) "Effect of antacids on salicylate kinetics." Int J Clin Pharmacol Ther Toxicol, 23, p. 480-4
  7. Covington TR, eds., Lawson LC, Young LL (1993) "Handbook of Nonprescription Drugs." Washington, DC: American Pharmaceutical Association
  8. Brouwers JRBJ, Desmet PAGM (1994) "Pharmacokinetic-pharmacodynamic drug interactions with nonsteroidal anti-inflammatory drugs." Clin Pharmacokinet, 27, p. 462-85
  9. (2023) "Product Information. Diflunisal (diflunisal)." Chartwell RX, LLC.
View all 9 references

Switch to consumer interaction data

Moderate

rifAMPin magnesium hydroxide

Applies to: rifampin and Magnaprin (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide)

ADJUST DOSING INTERVAL: Limited data suggest that some antacids may decrease the oral bioavailability of rifampin. The mechanisms include decreased dissolution of rifampin in the presence of increased gastric pH and/or aluminum chelation with rifampin. The clinical significance has not been established.

MANAGEMENT: Rifampin should be administered at least 1 hour before antacids. Monitoring for altered therapeutic effect is advisable.

References

  1. (2001) "Product Information. Rifadin (rifampin)." Hoechst Marion Roussel

Switch to consumer interaction data

Moderate

aspirin magnesium hydroxide

Applies to: Magnaprin (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide) and Magnaprin (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide)

MONITOR: Chronic administration of antacids may reduce serum salicylate concentrations in patients receiving large doses of aspirin or other salicylates. The mechanism involves reduction in salicylate renal tubular reabsorption due to urinary alkalinization by antacids, resulting in increased renal salicylate clearance. In three children treated with large doses of aspirin for rheumatic fever, serum salicylate levels declined 30% to 70% during coadministration with a magnesium and aluminum hydroxide antacid. Other studies have found similar, albeit less dramatic results. Antacids reportedly have no effect on the oral bioavailability of aspirin in healthy adults. However, administration of antacids containing either aluminum and magnesium hydroxide or calcium carbonate two hours before aspirin dosing led to reduced absorption of aspirin in uremic patients.

MANAGEMENT: Patients treated chronically with antacids (or oral medications that contain antacids such as didanosine buffered tablets or pediatric oral solution) and large doses of salicylates (i.e. 3 g/day or more) should be monitored for potentially diminished or inadequate analgesic and anti-inflammatory effects, and the salicylate dosage adjusted if necessary.

References

  1. D'Arcy PF, McElnay JC (1987) "Drug-antacid interactions: assessment of clinical importance." Drug Intell Clin Pharm, 21, p. 607-17
  2. Gaspari F, Vigano G, Locatelli M, Remuzzi G (1988) "Influence of antacid administrations on aspirin absorption in patients with chronic renal failure on maintenance hemodialysis." Am J Kidney Dis, 11, p. 338-42
  3. Furst DE (1988) "Clinically important interactions of nonsteroidal antiinflammatory drugs with other medications." J Rheumatol Suppl, 17, p. 58-62
  4. Miners JO (1989) "Drug interactions involving aspirin (acetylsalicylic acid) and salicylic acid." Clin Pharmacokinet, 17, p. 327-44
  5. Levy G, Lampman T, Kamath BL, Garrettson LK (1975) "Decreased serum salicylate concentrations in children with rheumatic fever treated with antacid." N Engl J Med, 293, p. 323-5
  6. Shastri RA (1985) "Effect of antacids on salicylate kinetics." Int J Clin Pharmacol Ther Toxicol, 23, p. 480-4
  7. Covington TR, eds., Lawson LC, Young LL (1993) "Handbook of Nonprescription Drugs." Washington, DC: American Pharmaceutical Association
  8. Brouwers JRBJ, Desmet PAGM (1994) "Pharmacokinetic-pharmacodynamic drug interactions with nonsteroidal anti-inflammatory drugs." Clin Pharmacokinet, 27, p. 462-85
  9. (2023) "Product Information. Diflunisal (diflunisal)." Chartwell RX, LLC.
View all 9 references

Switch to consumer interaction data

Drug and food interactions

Major

aluminum hydroxide food

Applies to: Magnaprin (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide)

GENERALLY AVOID: The concomitant administration of aluminum-containing products (e.g., antacids and phosphate binders) and citrates may significantly increase serum aluminum concentrations, resulting in toxicity. Citrates or citric acid are contained in numerous soft drinks, citrus fruits, juices, and effervescent and dispersible drug formulations. Citrates enhance the gastrointestinal absorption of aluminum by an unknown mechanism, which may involve the formation of a soluble aluminum-citrate complex. Various studies have reported that citrate increases aluminum absorption by 4.6- to 50-fold in healthy subjects. Patients with renal insufficiency are particularly at risk of developing hyperaluminemia and encephalopathy. Fatalities have been reported. Patients with renal failure or on hemodialysis may also be at risk from soft drinks and effervescent and dispersible drug formulations that contain citrates or citric acid. It is unknown what effect citrus fruits or juices would have on aluminum absorption in healthy patients.

MANAGEMENT: The concomitant use of aluminum- and citrate-containing products and foods should be avoided by renally impaired patients. Hemodialysis patients should especially be cautioned about effervescent and dispersible over-the-counter remedies and soft drinks. Some experts also recommend that healthy patients should separate doses of aluminum-containing antacids and citrates by 2 to 3 hours.

ADJUST DOSING INTERVAL: The administration of aluminum-containing antacids with enteral nutrition may result in precipitation, formation of bezoars, and obstruction of feeding tubes. The proposed mechanism is the formation of an insoluble complex between the aluminum and the protein in the enteral feeding. Several cases of esophageal plugs and nasogastric tube obstructions have been reported in patients receiving high-protein liquids and an aluminum hydroxide-magnesium hydroxide antacid or an aluminum hydroxide antacid.

MANAGEMENT: Some experts recommend that antacids should not be mixed with or given after high protein formulations, that the antacid dose should be separated from the feeding by as much as possible, and that the tube should be thoroughly flushed before administration.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT (2009) "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm, 66, p. 1438-67

Switch to consumer interaction data

Moderate

rifAMPin food

Applies to: rifampin

GENERALLY AVOID: Concurrent use of rifampin in patients who ingest alcohol daily may result in an increased incidence of hepatotoxicity. The increase in hepatotoxicity may be due to an additive risk as both alcohol and rifampin are individually associated with this adverse reaction. However, the exact mechanism has not been established.

ADJUST DOSING INTERVAL: Administration with food may reduce oral rifampin absorption, increasing the risk of therapeutic failure or resistance. In a randomized, four-period crossover phase I study of 14 healthy male and female volunteers, the pharmacokinetics of single dose rifampin 600 mg were evaluated under fasting conditions and with a high-fat meal. Researchers observed that administration of rifampin with a high-fat meal reduced rifampin peak plasma concentration (Cmax) by 36%, nearly doubled the time to reach peak plasma concentration (Tmax) but reduced overall exposure (AUC) by only 6%.

MANAGEMENT: The manufacturer of oral forms of rifampin recommends administration on an empty stomach, 30 minutes before or 2 hours after meals. Patients should be encouraged to avoid alcohol or strictly limit their intake. Patients who use alcohol and rifampin concurrently or have a history of alcohol use disorder may require additional monitoring of their liver function during treatment with rifampin.

References

  1. (2022) "Product Information. Rifampin (rifAMPin)." Akorn Inc
  2. (2022) "Product Information. Rifampicin (rifampicin)." Mylan Pharmaceuticals Inc
  3. (2023) "Product Information. Rifadin (rifampicin)." Sanofi
  4. (2024) "Product Information. Rifadin (rifaMPICin)." Sanofi-Aventis Australia Pty Ltd
  5. Peloquin CA, Namdar R, Singleton MD, Nix DE (2024) Pharmacokinetics of rifampin under fasting conditions, with food, and with antacids https://pubmed.ncbi.nlm.nih.gov/9925057/
  6. (2019) "Product Information. Rofact (rifampin)." Bausch Health, Canada Inc.
View all 6 references

Switch to consumer interaction data

Moderate

calcium carbonate food

Applies to: Magnaprin (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide)

ADJUST DOSING INTERVAL: Administration with food may increase the absorption of calcium. However, foods high in oxalic acid (spinach or rhubarb), or phytic acid (bran and whole grains) may decrease calcium absorption.

MANAGEMENT: Calcium may be administered with food to increase absorption. Consider withholding calcium administration for at least 2 hours before or after consuming foods high in oxalic acid or phytic acid.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
  3. Cerner Multum, Inc. "Australian Product Information."
  4. Agencia Española de Medicamentos y Productos Sanitarios Healthcare (2008) Centro de información online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html
  5. Mangels AR (2014) "Bone nutrients for vegetarians." Am J Clin Nutr, 100, epub
  6. Davies NT (1979) "Anti-nutrient factors affecting mineral utilization." Proc Nutr Soc, 38, p. 121-8
View all 6 references

Switch to consumer interaction data

Moderate

aspirin food

Applies to: Magnaprin (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide)

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

References

  1. (2002) "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn

Switch to consumer interaction data

Minor

aspirin food

Applies to: Magnaprin (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide)

One study has reported that coadministration of caffeine and aspirin lead to a 25% increase in the rate of appearance and 17% increase in maximum concentration of salicylate in the plasma. A significantly higher area under the plasma concentration time curve of salicylate was also reported when both drugs were administered together. The exact mechanism of this interaction has not been specified. Physicians and patients should be aware that coadministration of aspirin and caffeine may lead to higher salicylate levels faster.

References

  1. Yoovathaworn KC, Sriwatanakul K, Thithapandha A (1986) "Influence of caffeine on aspirin pharmacokinetics." Eur J Drug Metab Pharmacokinet, 11, p. 71-6

Switch to consumer interaction data

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

Loading...
QR code containing a link to this page

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.

Medical Disclaimer