Drug Interaction Report
3 potential interactions and/or warnings found for the following 2 drugs:
- citric acid/sodium bicarbonate
- cyanocobalamin / folic acid / pyridoxine / strontium gluconate
Interactions between your drugs
sodium bicarbonate strontium gluconate
Applies to: citric acid/sodium bicarbonate, cyanocobalamin / folic acid / pyridoxine / strontium gluconate
Administration of aluminum or magnesium hydroxide may impair the absorption of strontium. When aluminum and magnesium hydroxides were administered either two hours before or simultaneously with strontium ranelate, strontium systemic exposure (AUC) decreased by 20% to 25%. Absorption was not significantly affected when the antacid was given two hours following strontium ranelate dosing. Antacids should preferably be taken at least two hours after strontium administration if possible. However, they may be taken together if this dosing regimen is impractical due to the recommended administration of strontium salts at bedtime.
References (1)
- (2007) "Product Information. Bonisara (cyanocobalamin/folic acid/pyridoxine/strontiu)." Zylera Pharamaceuticals
Drug and food interactions
folic acid food
Applies to: cyanocobalamin / folic acid / pyridoxine / strontium gluconate
MONITOR: Ethanol may increase folic acid elimination and folic acid absorption is decreased in chronic alcoholics. Excessive alcohol consumption may lead to folate deficiency.
MANAGEMENT: Monitoring of patient response to folic acid supplementation if they also consume alcohol regularly may be recommended.
References (5)
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
- 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
- Cerner Multum, Inc (2015) "ANVISA Bulário Eletrônico."
- (2017) "Product Information. Folic Acid (folic acid)." Method Pharmaceuticals, LLC
strontium gluconate food
Applies to: cyanocobalamin / folic acid / pyridoxine / strontium gluconate
ADJUST DOSING INTERVAL: Concomitant administration of strontium with food or milk products may decrease its bioavailability by 60% to 70%.
MANAGEMENT: Strontium salts should be taken at least two hours before or two hours after food or milk products, and preferably at bedtime.
References (1)
- (2007) "Product Information. Bonisara (cyanocobalamin/folic acid/pyridoxine/strontiu)." Zylera Pharamaceuticals
Therapeutic duplication warnings
No duplication 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.
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. |
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Further information
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