Adoxa Pak and Ferric citrate
Determining the interaction of Adoxa Pak and Ferric citrate 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:Ferric citrate can bind to doxycycline in the gastrointestinal tract. This may inactivate ferric citrate and also interfere with the absorption of doxycycline into the bloodstream. The effectiveness of both medications may be reduced. To avoid or minimize the interaction, doxycycline should be taken at least one to four hours before ferric citrate. 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:ADJUST DOSING INTERVAL: 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. The interaction has not been studied in vivo with ferric citrate, but has been reported with ferrous sulfate. 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%. In vitro, doxycycline exhibited the potential for interaction with ferric citrate, with at least 70% decrease in its concentration.
MANAGEMENT: Doxycycline should be administered at least one hour before ferric citrate according to the manufacturer. Omadacycline administration with ferric citrate should be separated by 4 hours. No recommendations are available for coadministration with other tetracyclines.
- "Product Information. Auryxia (ferric citrate)." Keryx Biopharmaceuticals, Inc., New York, NY.
- "Product Information. Nuzyra (omadacycline)." Paratek Pharmaceuticals, Inc., Boston, MA.
- "Product Information. Seysara (sarecycline)." Allergan Inc, Irvine, CA.
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: ferric citrate
Brand name: Auryxia
Synonyms: Ferric Citrate
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.
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- Adoxa Pak-Ferric-x 150
- Ferric citrate-Adoxa Pak 1/100
- Ferric citrate-Adoxa Pak 1/150
- Ferric citrate-Adoxa TT
- Ferric citrate-Adrenaclick
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