Adoxa Pak and Ferrex 150 Forte Plus
Determining the interaction of Adoxa Pak and Ferrex 150 Forte Plus 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: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.
- 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
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 Pak 1/100
Generic Name: multivitamin with iron
Brand name: Ferrex 150 Forte Plus, Ferrex 28, Iron 21/7, Iron-150, Multigen Folic, Ultra Enerforce
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.
- Adoxa Pak-Ferrex 28
- Adoxa Pak-Ferrex-150
- Adoxa Pak-Ferric carboxymaltose
- Adoxa Pak-Ferric carboxymaltose Intravenous
- Adoxa Pak-Ferric citrate
- Adoxa Pak-Ferric Citrate Tablets
- Ferrex 150 Forte Plus-Adoxa Pak 1/100
- Ferrex 150 Forte Plus-Adoxa Pak 1/150
- Ferrex 150 Forte Plus-Adoxa TT
- Ferrex 150 Forte Plus-Adrenaclick
- Ferrex 150 Forte Plus-Adrenalin
- Ferrex 150 Forte Plus-Adrenalin (EPINEPHrine (Nasal))