AcipHex Sprinkle and Ferrous Sulfate Liquid
Determining the interaction of AcipHex Sprinkle and Ferrous Sulfate Liquid and the possibility of their joint administration.
In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.
Consumer:If you are iron-deficient or have anemia, you should talk to your doctor before using ferrous sulfate together with RABEprazole. By reducing stomach acid, RABEprazole may reduce the absorption of iron and make ferrous sulfate less effective in treating your condition. Your doctor or pharmacist may be able to offer suggestions on safer alternatives if you require treatment for stomach acid or ulcer while you are being treated with ferrous sulfate. 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.
Professional:MONITOR: The profound hypochlorhydria induced by proton pump inhibitors (PPIs) may impair the gastrointestinal absorption of nonheme iron, a process that is dependent on an acidic environment. The interaction was suspected in two patients with iron deficiency anemia due to gastrointestinal blood loss that were unresponsive to oral iron replacement therapy, even after the bleeding had apparently stopped. Both patients had been on omeprazole for six months while being treated with ferrous sulfate. An iron-loading test was performed on one of the patients and indicated iron malabsorption. Within two months after discontinuation of omeprazole, notable improvements in hemoglobin level and mean corpuscular volume (MCV) were observed in both patients, and iron absorption was significantly increased in the patient who underwent absorption testing. In a case review of patients with hereditary hemochromatosis treated at one institution, investigators observed a reduced requirement for maintenance phlebotomy in seven patients following initiation of PPI therapy (mean 2.5 L blood removed/year before PPI therapy vs. 0.5 L/year during PPI therapy), presumably due to reduced tissue iron accumulation stemming from impaired absorption of dietary nonheme iron. Mean annual phlebotomy requirement during PPI therapy in these patients was also lower than that in controls who had never taken a PPI (mean 2.3 L blood removed/year). The same group of investigators also studied iron absorption in 14 patients fed an iron-loaded meal before and after PPI therapy for one week. PPI therapy was associated with a 51% reduction in area under the serum iron concentration-time curve (AUC 0 to 4 hours); a 55% reduction in maximum increase of serum iron following ingestion of iron-loaded meal; and a 46% reduction in percent recovery of administered iron at peak serum iron concentration. Interestingly, the interaction has not been reported in healthy, iron-replete individuals. In a study of 109 patients with Zollinger-Ellison syndrome who had not undergone gastric resection, omeprazole treatment for an average of 5.7 years did not significantly decrease body iron stores or cause iron deficiency compared to H2-receptor antagonist therapy or no gastric acid-suppressant treatment. It is possible that the interaction may not affect people with healthy iron stores because of compensation by dietary heme iron, which typically comprises only a small fraction of dietary iron but whose absorption is not dependent on gastrointestinal pH. In contrast, dietary heme iron alone may not be sufficient to restore normal iron balance in patients with anemia or those with defective regulatory mechanisms of iron absorption.
MANAGEMENT: Patients with iron deficiency may not respond adequately to oral iron replacement therapy during coadministration of proton pump inhibitors. If an interaction is suspected after ruling out other causes, it may be appropriate to discontinue the proton pump inhibitor or consider administering iron parenterally.
- "Product Information. Prilosec (omeprazole)." Merck & Co, Inc, West Point, PA.
- "Product Information. Kapidex (dexlansoprazole)." Takeda Pharmaceuticals America, Lincolnshire, IL.
- Hutchison C, Geissler CA, Powell JJ, Bomford A "Proton pump inhibitors suppress absorption of dietary non-haem iron in hereditary haemochromatosis." Gut 56 (2007): 1291-5
- "Product Information. Protonix (pantoprazole)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
- Sharma VR, Brannon MA, Carloss EA "Effect of omeprazole on oral iron replacement in patients with iron deficiency anemia." South Med J 97 (2004): 887-9
- Nand S, Tanvetyanon T "Proton pump inhibitors and iron deficiency: is the connection real?" South Med J 97 (2004): 799
- "Product Information. Aciphex (rabeprazole)" Janssen Pharmaceuticals, Titusville, NJ.
- Stewart CA, Termanini B, Sutliff VE, et al "Iron absorption in patients with Zollinger-Ellison syndrome treated with long-term gastric acid antisecretory therapy." Aliment Pharmacol Ther 12 (1998): 83-98
- "Product Information. Nexium (esomeprazole)" Astra-Zeneca Pharmaceuticals, Wilmington, DE.
- "Product Information. Prevacid (lansoprazole)." TAP Pharmaceuticals Inc, Deerfield, IL.
Generic Name: rabeprazole
Brand name: Aciphex, AcipHex Sprinkle
Synonyms: Aciphex Sprinkle
Generic Name: ferrous sulfate
Brand name: Feosol, Fer Iron, Fer-Gen-Sol, Fer-in-Sol, Fer-Iron, Feratab, FeroSul, Ferra-TD, Ferro-Bob, Lydia E. Pinkham, MyKidz Iron 10, Slow Fe, Fe Caps, Fer-in-Sol, Ferra TD. Caps, Ferrousal, Slow Release Iron
Synonyms: Ferrous Sulfate
In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.
- AcipHex Sprinkle-Ferrous Sulfate Tablets
- AcipHex Sprinkle-Ferrousal
- AcipHex Sprinkle-Fertinex
- AcipHex Sprinkle-Ferumoxytol
- AcipHex Sprinkle-Ferumoxytol Intravenous
- AcipHex Sprinkle-Ferus Pic-150
- Ferrous Sulfate Liquid-Acitretin
- Ferrous Sulfate Liquid-Acitretin Capsules
- Ferrous Sulfate Liquid-Aclasta
- Ferrous Sulfate Liquid-Aclidinium
- Ferrous Sulfate Liquid-Aclidinium and Formoterol
- Ferrous Sulfate Liquid-Aclidinium Bromide