Interactions between Sodium bicarbonate and Triveen-One
1 drug interaction and 6 additional warnings found for the following 2 drugs:
- sodium bicarbonate
- Triveen-One (multivitamin, prenatal)
Drug interactions
Moderate drug interactions
Moderate:
sodium bicarbonate multivitamins, prenatal
Applies to: sodium bicarbonate and Triveen-One (multivitamin, prenatal)
Adjust dosing interval
The bioavailability of orally administered iron may be reduced by concomitant administration of antacids or other agents with acid-neutralizing effects. The exact mechanism is unknown but may involve reduced iron solubility due to increase in gastric pH and/or reduced absorption due to complexation or precipitation of the iron. Based on existing data, sodium bicarbonate and calcium carbonate appear to have greater effects than antacids containing magnesium and aluminum hydroxides. In a study of patients with mild iron deficiency anemia, coadministration of ferrous sulfate with sodium bicarbonate 1 gram and calcium carbonate 500 mg reduced iron absorption by 50% and 67%, respectively, while 5 mL of an antacid containing magnesium and aluminum hydroxides had little effect. Another study also found no effect on iron absorption when ferrous sulfate (equivalent to 10 mg/kg of elemental iron) was coadministered with magnesium hydroxide (1 mg for every 5 mg of elemental iron ingested) in a group of healthy, fasting male subjects. In contrast, absorption of iron from ferrous sulfate and ferrous fumarate tablets was reduced by 37% and 31%, respectively, following administration of an antacid containing magnesium carbonate, magnesium hydroxide, and aluminum hydroxide in a study of healthy, iron-replete volunteers. Similarly, in a study of nine patients, coadministration of 5 mg of ferrous sulfate with a 35 gram dose of magnesium trisilicate was found to reduce iron absorption by an average of more than 70%. The interaction reportedly does not occur in the presence of ascorbic acid, which may competitively bind with iron and prevent the interference with iron absorption.
Management
To minimize the potential for interaction, it may be appropriate to administer oral iron preparations at least two hours apart from antacids or other agents with acid-neutralizing effects.
References (12)
- O'Neil-Cutting MA, Crosby WH (1986) "The effect of antacids on the absorption of simultaneously ingested iron." JAMA, 255, p. 1468-70
- Hall GJ, Davis AE (1969) "Inhibition of iron absorption by magnesium trisilicate." Med J Aust, 2, p. 95-6
- Coste JF, de Bari VA, Keil LB, Needle MA (1977) "In-vitro interactions of oral hematinics." Curr Ther Res Clin Exp, 22, p. 205-15
- Corby DG, McCullen AH, Chadwick EW, Decker WJ "Effect of orally administered magnesium hydroxide in experimental iron intoxication." J Toxicol Clin Toxicol, 23, p. 489-99
- Gugler R, Allgayer H (1990) "Effects of antacids on the clinical pharmacokinetics of drugs. An update." Clin Pharmacokinet, 18, p. 210-9
- Rastogi SP, Padilla F, Boyd CM (1975) "Effect of aluminum hydroxide on iron absorption." Kidney Int, 8, p. 417
- Ekenved G, Halvorsen L, Solvell L (1976) "Influence of a liquid antacid on the absorption of different iron salts." Scand J Haematol, Suppl 28, p. 65-77
- Coste JF, De Barbi VA, Keil LB, Needle MA (1977) "In-vitro interactions of oral hemantics and antacid suspensions." Curr Ther Res Clin Exp, 22, p. 205-16
- Snyder BK, Clark RF (1999) "Effect of magnesium hydroxide administration on iron absorption after a supratherapeutic dose of ferrous sulfate in human volunteers: A randomized controlled trial." Ann Emerg Med, 33, p. 400-5
- Wallace KL, Curry SC, LoVecchio F, Raschke R (1999) "Effect of magnesium hydroxide on iron absorption after ferrous sulfate." Ann Emerg Med, 34, p. 685-6
- Pruchnicki MC, Coyle JD, Hoshaw-Woodard S, Bay WH (2002) "Effect of phosphate binders on supplemental iron absorption in healthy subjects." J Clin Pharmacol, 42, p. 1171-6
- (2010) "Product Information. Suprep Bowel Prep Kit (magnesium/potassium/sodium sulfates)." Braintree Laboratories
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
multivitamins, prenatal Food/Lifestyle
Applies to: Triveen-One (multivitamin, prenatal)
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
Disease interactions
5 potential interactions Applies to: 5 conditions, including Heart Failure, Fluid Retention, Renal Dysfunction, Hypernatremia, and Alkalosis.
Alkalosis
Moderate:
sodium bicarbonate
Sodium bicarbonate has a moderate potential interaction with Alkalosis.
Alkalinizing agents act as proton acceptors and/or dissociate to provide bicarbonate ions. Elimination of bicarbonate is decreased in patients with renal impairment and can result in metabolic alkalosis. Symptoms of metabolic alkalosis include hyperirritability or tetany, arrhythmia, and/or seizures (altered pH = altered calcium), or lactic acidosis due to impaired oxygen release. Therapy with alkalinizing agents should be administered with extreme caution in patients with compromised renal function. Clinical monitoring of renal function, acid/base balance and electrolytes is recommended.
Fluid Retention
Major:
sodium bicarbonate
Sodium bicarbonate has a major potential interaction with Fluid Retention.
Alkalinizing agents containing sodium can induce sodium and water retention and result in hypernatremia, hypokalemia, hyperosmolality, edema and aggravation of congestive heart failure. Therapy with sodium- containing alkalinizing agents should not be used in patients with hypernatremia or fluid retention. Clinical monitoring of acid/base balance and electrolytes prior to, during, a following completion of therapy with alkalinizing agents is recommended.
Heart Failure
Major:
sodium bicarbonate
Sodium bicarbonate has a major potential interaction with Heart Failure.
Alkalinizing agents containing sodium can induce sodium and water retention and result in hypernatremia, hypokalemia, hyperosmolality, edema and aggravation of congestive heart failure. Therapy with sodium- containing alkalinizing agents should not be used in patients with hypernatremia or fluid retention. Clinical monitoring of acid/base balance and electrolytes prior to, during, a following completion of therapy with alkalinizing agents is recommended.
Hypernatremia
Major:
sodium bicarbonate
Sodium bicarbonate has a major potential interaction with Hypernatremia.
Alkalinizing agents containing sodium can induce sodium and water retention and result in hypernatremia, hypokalemia, hyperosmolality, edema and aggravation of congestive heart failure. Therapy with sodium- containing alkalinizing agents should not be used in patients with hypernatremia or fluid retention. Clinical monitoring of acid/base balance and electrolytes prior to, during, a following completion of therapy with alkalinizing agents is recommended.
Renal Dysfunction
Moderate:
sodium bicarbonate
Sodium bicarbonate has a moderate potential interaction with Renal Dysfunction.
Alkalinizing agents act as proton acceptors and/or dissociate to provide bicarbonate ions. Elimination of bicarbonate is decreased in patients with renal impairment and can result in metabolic alkalosis. Symptoms of metabolic alkalosis include hyperirritability or tetany, arrhythmia, and/or seizures (altered pH = altered calcium), or lactic acidosis due to impaired oxygen release. Therapy with alkalinizing agents should be administered with extreme caution in patients with compromised renal function. Clinical monitoring of renal function, acid/base balance and electrolytes is recommended.
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sodium bicarbonate
A total of 179 drugs are known to interact with sodium bicarbonate.
- Sodium bicarbonate is in the following drug classes: antacids, minerals and electrolytes, urinary pH modifiers.
- Sodium bicarbonate is used to treat the following conditions:
Triveen-One
A total of 172 drugs are known to interact with Triveen-One.
- Triveen-one is in the following drug classes: iron products, vitamin and mineral combinations.
- Triveen-one is used to treat Vitamin/Mineral Supplementation during Pregnancy/Lactation.
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.