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Drug Interactions between Niferex-150 and sucralfate

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

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Interactions between your drugs

Moderate

sucralfate ascorbic acid

Applies to: sucralfate and Niferex-150 (ascorbic acid/iron polysaccharide)

MONITOR: In patients with advanced renal impairment or on dialysis, chronic use of aluminum-containing preparations while taking high doses of ascorbic acid may result in increased blood levels of aluminum and aluminum toxicity. Patients with renal failure are at risk for toxicity due to impaired clearance of aluminum, and the risk may be further increased by the administration high dose Vitamin C due to increased intestinal absorption of aluminum. Toxicity may manifest as osteodystrophy, osteomalacia, myopathy, anemia, and encephalopathy.

MANAGEMENT: Concomitant use of ascorbic acid in doses above the recommended dietary allowance with aluminum-containing products should be avoided in patients with renal failure. If higher doses of ascorbic acid are required, monitor for signs and symptoms of aluminum toxicity and consider monitoring serum phosphate levels.

References

  1. Fairweather-Tait S, Hickson K, McGaw B, Reid M (1994) "Orange juice enhances aluminium absorption from antacid preparation." Eur J Clin Nutr, 48, p. 71-3
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."

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Drug and food interactions

Moderate

sucralfate food

Applies to: sucralfate

ADJUST DOSING INTERVAL: The administration of sucralfate with enteral nutrition may result in precipitation and the formation of bezoars that may obstruct feeding tubes. The proposed mechanism is the formation of an insoluble aluminum-protein complex between the aluminum in the sucralfate and the protein in the enteral feeding. In addition, sucralfate may not become activated due to the alkaline pH of enteral nutrition products.

MANAGEMENT: Some experts recommend separating the sucralfate doses from enteral feedings by at least 1 hour. Alternatively, consideration may be given to proton pump inhibitors or H2 antagonists.

References

  1. 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

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Moderate

iron polysaccharide food

Applies to: Niferex-150 (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

  1. "Product Information. Feosol (ferrous sulfate)." SmithKline Beecham
  2. (2021) "Product Information. Accrufer (ferric maltol)." Shield Therapeutics

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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.

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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.

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