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Calcium and Vitamin D Chewable Tablets and Cardioquin

Determining the interaction of Calcium and Vitamin D Chewable Tablets and Cardioquin and the possibility of their joint administration.

Check result:
Calcium and Vitamin D Chewable Tablets <> Cardioquin
Relevance: 10.10.2023 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:

Calcium carbonate may increase the blood levels and effects of quiNIDine in some people. Contact your doctor if you experience ringing in the ears, hearing loss, visual problems, diarrhea, headache, dizziness, lightheadedness, fainting, or fast or pounding heartbeats during treatment with these medications, as they may be symptoms of excessive effects of quiNIDine. You may need a dose adjustment or special tests to safely use both medications. 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: Coadministration with drugs that can increase urinary pH such as antacids, carbonic anhydrase inhibitors, or urinary alkalinizers may decrease the urinary excretion of quinidine. The proposed mechanism is increased renal tubular reabsorption due to reduced ionization of quinidine in alkaline urine. In four healthy subjects given quinidine 200 mg every 6 hours, renal clearance of quinidine was reduced by an average of 50% during coadministration with sodium bicarbonate and acetazolamide 500 mg twice a day. Average urinary quinidine level was 115 mg/L at urinary pH below 6, but fell to 13 mg/L at urinary pH above 7.5. Likewise, average quinidine urinary excretion rate fell from 103 to 31 mcg/minute with increasing pH. In another six healthy subjects studied under the same conditions, increased serum quinidine levels were observed in five subjects during urine alkalinization, and prolongations of the QT interval were reported in three of the five. Since only about 20% of a quinidine dose is typically eliminated unchanged by the kidney, the clinical significance of this interaction is unknown. A case report describes a woman who developed toxicity in association with a threefold increase in serum quinidine levels after taking eight Mylanta antacid tablets (each containing 200 mg aluminum hydroxide gel, 200 mg magnesium hydroxide, and 20 mg simethicone) everyday for a week. However, the patient also drank over a liter of orange and grapefruit juice daily, the latter of which can inhibit quinidine metabolism and may have contributed to the toxic drug levels. In pharmacokinetic studies, single doses of aluminum hydroxide alone had no significant effect on quinidine pharmacokinetics or urinary pH, although the possibility of a significant interaction in occasional patients cannot be ruled out.

MANAGEMENT: Caution is advised if quinidine is used with agents that can increase urinary pH. Quinidine levels may need to be monitored more closely following addition or discontinuation of these agents, and the quinidine dosage adjusted as necessary. Patients should be advised to seek medical attention if they experience symptoms that could indicate quinidine toxicity such as tinnitus, hearing loss, visual disturbances, diarrhea, headache, dizziness, palpitations, syncope, or irregular heartbeats.

References
  • Ace LN, Jaffe JM, Kunka RL "Effect of food and an antacid on quinidine bioavailability." Biopharm Drug Dispos 4 (1983): 183-90
  • Romankiewicz JA, Reidenberg M, Drayer D, Franklin JE "The noninterference of aluminum hydroxide gel with quinidine sulfate absorption: An approach to control quinidine-induced diarrhea." Am Heart J 96 (1978): 518-20
  • Mauro VF, Mauro LS, Fraker TD Jr, Temesy-Armos PN, Somani P "Effect of aluminum hydroxide gel on quinidine gluconate absorption." DICP 24 (1990): 252-4
  • Gerhardt RE, Knouss RF, Thyrum PT, et al "Quinidine excretion in aciduria and alkaluria." Ann Intern Med 71 (1969): 927-33
  • Zinn MB "Quinidine intoxication from alkali ingestion." Tex Med 66 (1970): 64-6
Calcium and Vitamin D Chewable Tablets

Generic Name: calcium / vitamin d

Brand name: Calcitrate with D, Caltrate 600+D Soft Chews, Citracal + D, Os-Cal Extra D3, Oystercal-D, UpCal D, Os-Cal 250 with D, Oysco D, Dical-D, Calcet, Oyster Shell Calcium with Vitamin D, O-Cal-D, Oyster-D, Oyst-Cal-D, Caltro with Vitamin D, Oysco 500 with D, Oysco D with Calcium, Os-Cal with D, Caltrate 600 with D, Calcarb with D, Posture-D H/P, Dical Captabs, Dicalphos plus D, Os-Cal 500 with D, Caltrate 600 with D Plus Soy, Caltrate Colon Health, Calvite P & D, Sedecal D, Chewable Calcium with Vitamin D, Osteocit D Plus, Os-Cal 500 + D, Citracal Petites, Citracal Creamy Bites, Citracal 250 mg + D, Calcio Del Mar, Citrus Calcium with Vitamin D, Calcium 600+D, Risacal-D, Liquid Calcium with Vitamin D, Citracal Maximum + D, Citracal Calcium + D Slow Release 1200, Citracal Calcium Gummies, Caltrate Gummy Bites, Super Calcium 600 + D3 400, Os-Cal Calcium+D3, Caltrate 600 + D, Citracal Regular, Calcet Petites, Calcium 500+D, D3 with Calcium, Calcitrate, Caltrate 600+D, Os-Cal 500+D, Os-Cal 500+Extra D Chewable

Synonyms: Calcium and vitamin D combination

Cardioquin

Generic Name: quinidine

Brand name: Quin-G, Cardioquin, Quinora, Quinidex Extentabs, Quinaglute Dura-Tabs, Quin-Release

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.