Drug Interaction Report

ADJUST DOSING INTERVAL: Aluminum-based antacids have been shown to adsorb bile acids in vitro and may be expected to interfere with the gastrointestinal absorption of chenodeoxycholic acid, which is a naturally occurring human bile acid.

MANAGEMENT: To minimize the potential for interaction, it may be helpful to separate the dosing of chenodeoxycholic acid and aluminum-based antacids by several hours. However, clinical data are lacking to support a recommendation.

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.