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Drug Interaction Report

4 potential interactions and/or warnings found for the following 2 drugs:

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Interactions between your drugs

Minor

pyridoxine butabarbital

Applies to: Bonisara (cyanocobalamin / folic acid / pyridoxine / strontium gluconate), butabarbital

One small study has suggested that pyridoxine may decrease serum levels of phenobarbital. The mechanism is unknown. Phenobarbital is the only barbiturate specifically implicated in this interaction. However, other barbiturates may behave in a similar fashion. Close observation for altered barbiturate effects is indicated if these drugs must be used together.

References (1)
  1. Hansson O, Sillanpaa M (1976) "Pyridoxine and serum concentration of phenytoin and phenobarbitone." Lancet, 1, p. 256

Drug and food interactions

Major

butabarbital food

Applies to: butabarbital

GENERALLY AVOID: Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.

MANAGEMENT: The combination of ethanol and barbiturates should be avoided.

References (5)
  1. Gupta RC, Kofoed J (1966) "Toxological statistics for barbiturates, other sedatives, and tranquilizers in Ontario: a 10-year survey." Can Med Assoc J, 94, p. 863-5
  2. Misra PS, Lefevre A, Ishii H, Rubin E, Lieber CS (1971) "Increase of ethanol, meprobamate and pentobarbital metabolism after chronic ethanol administration in man and in rats." Am J Med, 51, p. 346-51
  3. Saario I, Linnoila M (1976) "Effect of subacute treatment with hypnotics, alone or in combination with alcohol, on psychomotor skills related to driving." Acta Pharmacol Toxicol (Copenh), 38, p. 382-92
  4. Stead AH, Moffat AC (1983) "Quantification of the interaction between barbiturates and alcohol and interpretation of fatal blood concentrations." Hum Toxicol, 2, p. 5-14
  5. Seixas FA (1979) "Drug/alcohol interactions: avert potential dangers." Geriatrics, 34, p. 89-102
Moderate

folic acid food

Applies to: Bonisara (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)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."
  3. 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
  4. Cerner Multum, Inc (2015) "ANVISA Bulário Eletrônico."
  5. (2017) "Product Information. Folic Acid (folic acid)." Method Pharmaceuticals, LLC
Moderate

strontium gluconate food

Applies to: Bonisara (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)
  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.

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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.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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