Calcium Carbonate Chewable Tablets and Phenytoin Intravenous
Determining the interaction of Calcium Carbonate Chewable Tablets and Phenytoin Intravenous 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:Using calcium carbonate together with phenytoin may decrease the effects of phenytoin. Separate the times of administration of calcium carbonate and phenytoin by at least two to three hours. If your doctor does prescribe these medications together, you may need a dose adjustment or special test 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:ADJUST DOSING INTERVAL: Concurrent administration of antacids may decrease the bioavailability of phenytoin. The mechanism of interaction is unknown. In eight healthy volunteers, coadministration of a single 600 mg dose of phenytoin and an antacid containing either aluminum-magnesium hydroxide or calcium carbonate (dose equal to 160 mEq of neutralizing capacity) given one and three hours after meals and at bedtime on the same day resulted in an approximately 25% reduction in the total area under the concentration-time curve (AUC) of phenytoin compared to administration alone. An antacid containing aluminum hydroxide-magnesium trisilicate given in an equivalent dose also reduced the AUC of phenytoin, but the difference was not statistically significant. In another study, aluminum hydroxide-magnesium trisilicate caused a 12% reduction in steady-state serum phenytoin levels in six epileptic patients, but seizure frequency was not affected. There have also been isolated case reports of patients with low serum phenytoin levels or inadequate seizure control attributed to concurrent antacid administration. In a few of the patients, serum phenytoin levels rose two to threefold when antacid administration was delayed by 2 to 3 hours. However, some studies have failed to find a significant interaction with these antacids.
MANAGEMENT: Given the narrow therapeutic index and the large interindividual variability in the pharmacokinetics of phenytoin, patients requiring concomitant antacid therapy should consider separating the times of administration by at least two to three hours if possible. Serum phenytoin levels and seizure activity should be monitored.
- "Product Information. Dilantin (phenytoin)." Parke-Davis, Morris Plains, NJ.
- Carter BL, Garnett WR, Pellock JM, et al "Effects of antacids on phenytoin bioavailability." Ther Drug Monit 3 (1981): 333-40
- Kulshrestha K, Thomas M, Wadsworth J, Richens A "Interaction between phenytoin and antacids." Br J Clin Pharmacol 6 (1978): 177-9
- Chapron DJ, Kramer PA, Mariano SL, Hohnadel DC "Effect of calcium and antacids on phenytoin bioavailability." Arch Neurol 36 (1979): 436-8
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Generic Name: calcium carbonate
Brand name: Calci-Chew, Oysco 500, Calci Mix, Os-Cal 500, Oyst Cal 500, Oyster Shell Calcium 500, Nephro Calci, Amitone, Dicarbosil, Equilet, Tums, Chooz, Tums E-X, Alkets, Titralac, Oyster Cal 500, Calcitab, Oyster Shell, Oyster Calcium, Super Calcium, Calcium Concentrate, Caltro, Oyster, Oyster Cal, Cal Oys, Alkums, Cal-Gest, Tums 500, Tums Ultra, Alka-Mints, Calcarb, Caltrate, Rolaids Sodium Free, Amilac, Calcium Oyster, Oyst Cal, Calcium Liquid Softgel, Mylanta Child, Maalox Quick Dissolve, Maalox Quick Dissolve Maximum Strength, Ultra Mylanta Calci Tabs, Extra Strength Mylanta Calci Tabs, Os-Cal, Surpass, Surpass Extra Strength, Icar Prenatal Chewable Calcium, Tums Extra Strength, Maalox Quick Dissolve Extra Strength, Calcium Oyster Shell, Maalox Antacid Barrier, Rolaids Soft Chew, Pepto Children's, Maalox Regular Strength, Maalox Children's, Tums Kids, Tums QuikPak, Calci-Mix, Alcalak, Tums Smoothies, Tums Chewy Bites, Tums Chewy Delights, Tums Sugar-Free, Cal-Mint, Calci Mix, OsCal 500
Synonyms: Calcium carbonate, Calcium Carbonate
Generic Name: phenytoin
Brand name: Dilantin, Phenytek, Dilantin Infatabs, Phenytoin Sodium, Prompt
Synonyms: Phenytoin (Intravenous)
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.
- Calcium Carbonate Chewable Tablets-Phenytoin Oral Suspension
- Calcium Carbonate Chewable Tablets-Phenytoin Sodium
- Calcium Carbonate Chewable Tablets-Phenytoin Sodium, Prompt injection
- Calcium Carbonate Chewable Tablets-Phenytoin Suspension
- Calcium Carbonate Chewable Tablets-Philith
- Calcium Carbonate Chewable Tablets-Phillips Milk of Magnesia
- Phenytoin Intravenous-Calcium Carbonate Chewable Tablets (Antacid)
- Phenytoin Intravenous-Calcium Carbonate Suspension
- Phenytoin Intravenous-Calcium Carbonate Tablets (Antacid)
- Phenytoin Intravenous-Calcium carbonate, magnesium hydroxide, and simethicone
- Phenytoin Intravenous-Calcium Carbonate/Vit D/Vit B6/Vit B12/Folic Acid with Minerals Chew Wafers
- Phenytoin Intravenous-Calcium Chloride