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Adoxa CK and Hemax

Determining the interaction of Adoxa CK and Hemax and the possibility of their joint administration.

Check result:
Adoxa CK <> Hemax
Relevance: 01.08.2022 Reviewer: Shkutko P.M., M.D., in

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:

Iron can bind to doxycycline in the gastrointestinal tract, which may prevent their absorption into the bloodstream and possibly reduce their effectiveness. To avoid or minimize the interaction, iron-containing medications and doxycycline should preferably be taken at least three to four hours apart in most cases. Talk to your doctor if you have any questions or concerns, or if you have trouble separating the dosing times. Your doctor may be able to prescribe alternatives that do not interact. 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:

GENERALLY AVOID: The bioavailability of oral tetracyclines and iron salts may be significantly decreased during concurrent administration. Therapeutic failure may result. The proposed mechanism is chelation of tetracyclines by the iron cation, forming an insoluble complex that is poorly absorbed from the gastrointestinal tract. In ten healthy volunteers, simultaneous oral administration of ferrous sulfate 200 mg and single doses of various tetracyclines (200 mg to 500 mg) resulted in reductions in the serum levels of methacycline and doxycycline by 80% to 90%, oxytetracycline by 50% to 60%, and tetracycline by 40% to 50%. In another study, 300 mg of ferrous sulfate reduced the absorption of tetracycline by 81% and that of minocycline by 77%. Conversely, the absorption of iron has been shown to be decreased by up to 78% in healthy subjects and up to 65% in patients with iron depletion when ferrous sulfate 250 mg was administered with tetracycline 500 mg. Available data suggest that administration of iron 3 hours before or 2 hours after a tetracycline largely prevents the interaction with most tetracyclines except doxycycline. Due to extensive enterohepatic cycling, iron binding may occur with doxycycline even when it is given parenterally. It has also been shown that when iron is administered up to 11 hours after doxycycline, serum concentrations of doxycycline may still be reduced by 20% to 45%.

MANAGEMENT: Coadministration of a tetracycline with any iron-containing product should be avoided if possible. Otherwise, patients should be advised to stagger the times of administration by at least three to four hours, although separating the doses may not prevent the interaction with doxycycline.

References
  • Gothoni G, Neuvonen PJ, Mattila M, Hackman R "Iron-tetracycline interaction: effect of time interval between the drugs." Acta Med Scand 191 (1972): 409-11
  • Neuvonen PJ "Interactions with the absorption of tetracyclines." Drugs 11 (1976): 45-54
  • Neuvonen PJ, Penttila O "Effect of oral ferrous sulphate on the half-life of doxycycline in man." Eur J Clin Pharmacol 7 (1974): 361-3
  • Bateman FJ "Effects of tetracyclines." Br Med J 4 (1970): 802
  • Venho VM, Salonen RO, Mattila MJ "Modification of the pharmacokinetics of doxycycline in man by ferrous sulphate or charcoal." Eur J Clin Pharmacol 14 (1978): 277-80
  • "Product Information. Minocin (minocycline)." Lederle Laboratories, Wayne, NJ.
  • Greenberger NJ "Absorption of tetracyclines: interference by iron." Ann Intern Med 74 (1971): 792-3
  • "Product Information. Nuzyra (omadacycline)." Paratek Pharmaceuticals, Inc., Boston, MA.
  • Campbell NR, Hasinoff BB "Iron supplements: a common cause of drug interactions." Br J Clin Pharmacol 31 (1991): 251-5
  • "Product Information. Seysara (sarecycline)." Allergan Inc, Irvine, CA.
  • Neuvonen PJ, Gothoni G, Hackman R, Bjorksten K "Interference of iron with the absorption of tetracyclines in man." Br Med J 4 (1970): 532-4
Adoxa CK

Generic Name: doxycycline

Brand name: Acticlate, Adox Pak 2/100, Adoxa, Adoxa Pak 1/100, Adoxa Pak 1/150, Avidoxy, Monodox, Morgidox, Oraxyl, TargaDOX, Vibramycin, Adoxa CK, Adoxa Pak, Adoxa TT, Alodox, Avidoxy, Doryx, Mondoxyne NL, Oracea, Periostat Targadox, Vibramycin Calcium, Vibramycin Hyclate, Vibramycin monohydrate, Vibra-Tabs, Doxy 100, TargaDOX

Synonyms: Adoxa CK (Oral)

Hemax

Generic Name: multivitamin with minerals

Brand name: Glutofac-MX, Hemax, Advanced AM/PM, Berocca Plus, Vicon Forte, Prosteon, TheraCal D200, TheraCal D400, Ocuvite PreserVision, Protegra Softgel, Centavite, Daily Multi-Vitamins with Minerals, Strovite Advance, I-Sense OccuShield, Tab-A-Vite Maximum, Occuplex, ICaps AREDS, Siderol, Uni-Fac ZX, MagneBind 400 RX, Folgard OS, Dialyvite with Zinc Rx, Dialyvite 800 with Zinc, Dialyvite 800 with Zinc 15, CF Vite, Resource Optisource, High Potency, Tab-A-Vite Womens Formula, Tab-A-Vite WeightSlim, Dialyvite 3000, Udamin, Udamin SP, Vita Zx, CalciFol, Femtabs, Diatx Zn, Complete A-Z, Thera-Vite M, Ellis Tonic Sherry, Renax 55, O-CAL FA, ICaps MV, Viactiv Multi-Vitamin, Os-Cal Ultra, Opti-Gen, Encora, Disney Winnie the Pooh Complete, Disney Winnie the Pooh with Extra C, Disney Winnie the Pooh Gummies, Mag-SR with Calcium, Folpace Rx, Calafol Rx, Corvite, NIC 750, Tandem Plus, Multi-Day Plus Minerals, ABC Plus Senior, Certa-Vite Senior Plus Lutein, I-Vite Protect, CalciFolic-D, Ostiva, Daily-Vite Weight Control, One-A-Day WeightSmart, RenaPlex, Centrum Kids Complete Dora the Explorer, Centrum Kids Complete SpongeBob SquarePants, Centrum Kids Complete Variety, Caltrate 600 Plus, Ecee Plus, Viactiv Multi-Vitamin Flavor Glides, Viactiv Calcium Flavor Glides, Biotin Forte with Zinc, AquADEKs Pediatric, AquADEKs, Antioxidant Ultra Formula, Clusimar, Multi-betic, elon Matrix 5000 Complete, One-A-Day Women 50 Plus, One-A-Day Men 50 Plus, SourceCF Multivitamins with A, B, D, E & K plus Zinc, Vitamax, Corvite Free, Corvite 150, RE Fac-X, Vital-D, SourceCF Softgels, SourceCF Chewables, SourceCF Pediatric Drops, Magonate Tablets, Hemocyte Plus, Reocyte Plus, Re Dualvit F, Re Dualvit Plus, Folbee Plus CZ, Centrum Cardio, Renatabs with Iron, CertaVite with Lutein, Strovite Advance+D, Thera-M Enhanced, Ferrocite Plus, Risanoid Plus, Dialyvite 5000, Nicotinamide ZCF, Leg-Gesic, PreserVision, Children's Complete, Daily Multiple for Women, Spectravite Cardio Health, Daily Multiple for Women 50+, Daily Multiple for Men 50+, Eye Health Formula, elppa Daily, MaxiVision Eye Formula, MaxiVision Ocular Formula, MaxiVision Eye & Body Formula, MaxiVision Whole Body Formula, Nutiifac ZX, Recal Fol D, Centrum Women's, Centrum Silver Women's, Centrum Men's, Centrum Silver Men's, Strovite One, Vitatab MV, Megavite Rx, Nutravance, Super Theravite-M, Vitatrum, ProBarimin QT, One-A-Day Men Pro Edge, One-A-Day Vitacraves, Corvita, Centrum Kids, TL G-Fol OS, Corvita 150, Century Senior, Dialyvite 800 Ultra D, CertaVite with Antioxidants, NicAzel, Centratex, Spectravite Senior, Centrum Ultra Women's, Centrum Silver Ultra Women's, Centrum Ultra Men's, Centrum Silver Ultra Men's, Tozal, ICaps Lutein & Omega-3, Apetigen-Plus, Lysiplex Plus, Bladder 22, Essentia, 50 + Companion, Companion Multi, Prostate 24, TheraLith XR, ConceptionXR MSF, ConceptionXR RHF, Centrum Special Energy, Centrum Special Heart, TheraCal D2000, TheraCal D4000, TheraCal Rapid Repletion, Prosteon, Centrum Specialist Vision, PureVit DualFe Plus, PureFe Plus, Centamin, AKEDamins, Dialyvite Supreme D, VP-ZEL, Macular Vitamin Benefit, ProRenal Vital, ProRenal QD, Nutricap, Nutrivit, Lipoflavovit, Macular Health, Daily Multi, Centrum Flavor Burst, Centrum Special Immune, Folgard, Caltrate 600+D Plus Minerals, CertaVite Senior, Solo, NanoVM 1-3 Years, NanoVM 4-8 Years, Calcium 600+D Plus Minerals, Prosight with Lutein, Advanced Eye Health, PreserVision AREDS 2, ChoiceFul, Complete Formulation Softgels, Abatron, Corvite Fe, NicAzel Forte, Nicadan, DermaNIC, Active FE, Companion, CalMag Thins, ProCerv HP, Conception XR, Nature's Bounty Men's Hair Formula, Men's Hair Formula, Stress with Zinc, Somnicin, MaxFe, Puralor Ci with DHA, Star Wars Hero Gummies, Star Wars Villain Gummies, Star Wars Yoda Gummies, Citracal Plus Bone Density Builder, Star Wars, Centrum Adults, Caltrate 600+D Plus Minerals Minis, One-A-Day Mens 50+ Healthy Advantage, Emergen-C, Vitamin C plus Zinc, RenaPlex-D, Vol-Plus, Multigenics, Supervite EC, Supervite, Thyrosol, Se-Tan Plus, Centrum Silver Plus Vision, Complete Formulation, Ocuvite Eye + Multi, Complete Formulation Softgels D3000, Complete Formulation D5000, Complete Formulation D3000, Complete Formulation Pediatric Drops, Airborne Everyday, Airborne Dual Action, Airborne, Airborne Kids Gummies, Airborne Everyday Gummies, Airborne Gummies, Airborne Plus Energy, Celebrate Multivitamin, Celebrate Calcium Plus 500, Nicadan ZX, DEKAs Plus, Nicaprin, Astamed MYO, L'il Critters Gummy Vites, Theratrum Complete with Lutein and Lycopene, Theratrum Complete 50 Plus Lutein & Lycopene, Centravites 50 Plus, Macular Health Formula, Dry Eye Formula, MultiVitamin Plus Zinc, ABDEK Pediatric, ABDEK, Centravites Adults, Optisource Post Bariatric Surgery, Healthy Eyes with Lutein, Centrum MultiGummies Women, Centrum Vitamints, Genicin Vita-Q, Genicin Vita-S, Complete Formulation Minis, Theratrum Complete 50 Plus, DEKAs Bariatric, Emergen-C Energy Plus Orange Zest, Bariatric Multivitamins with 45 mg Iron, Folite, Geritol Tonic, SSS. Tonic, Vitalize, Fovex

Synonyms: n.a.

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.

Interaction with food and lifestyle
Disease interaction