Drug Interaction Report

Ask your doctor before using dihydroxyaluminum sodium carbonate together with calcium citrate. Using these medications together can increase the effects of dihydroxyaluminum sodium carbonate which could result in too high of aluminum blood levels. If you have end-stage renal disease you are particularly at risk of developing high aluminum blood levels and encephalopathy (brain disease). You should separate doses of dihydroxyaluminum sodium carbonate and calcium citrate by 2 to 3 hours. You may need a dose adjustment or special test if you use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Citrate, or citric acid, can increase the absorption of dihydroxyaluminum sodium carbonate. This may lead to elevated blood levels of aluminum, particularly in individuals with reduced kidney function, since aluminum is primarily eliminated by the kidneys. Excess aluminum may deposit and cause problems in various tissues including bone, brain, heart, liver, muscles, and spleen. Over time, weak bones, bone pain, fractures, skeletal deformity, brain disorders, and anemia may develop. Talk to your doctor before using dihydroxyaluminum sodium carbonate if you have kidney impairment or are on hemodialysis. You should avoid or limit the consumption of citrate-containing foods and beverages (e.G., soft drinks, citrus fruits, fruit juices) during treatment with dihydroxyaluminum sodium carbonate. Be aware that some effervescent and dispersible drug formulations may also contain citrate and should be restricted as well. Even if you do not have kidney problems, it may be best to separate the dosing of dihydroxyaluminum sodium carbonate and citrate-containing products by 2 to 3 hours. Talk to a healthcare professional if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

When dihydroxyaluminum sodium carbonate is taken during enteral nutrition therapy (tube feeding), the tube may get clogged. Therefore, dihydroxyaluminum sodium carbonate should not be mixed with or given after high-protein tube feedings. The dose should be separated from the feeding by as much as possible, and the tube should be thoroughly flushed before administration of the dose.

Calcium absorption may be increased by taking it with food. However, foods high in oxalic acid (spinach or rhubarb), or phytic acid (bran and whole grains) may decrease calcium absorption. Calcium may be taken with food to increase absorption. Consider spacing calcium administration for at least 2 hours before or after consuming foods high in oxalic acid or phytic acid. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.