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Calcium Carbonate Chewable Tablets (Antacid) and Inderal

Determining the interaction of Calcium Carbonate Chewable Tablets (Antacid) and Inderal and the possibility of their joint administration.

Check result:
Calcium Carbonate Chewable Tablets (Antacid) <> Inderal
Relevance: 17.08.2023 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:

Using propranolol together with calcium carbonate may decrease the effects of propranolol. Separate the administration times of propranolol and calcium carbonate by at least 2 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 with calcium salts may decrease the oral bioavailability of atenolol and possibly other beta-blockers. The exact mechanism of interaction is unknown. In six healthy subjects, calcium 500 mg (as lactate, carbonate, and gluconate) reduced the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of atenolol (100 mg) by 51% and 32%, respectively. The elimination half-life increased by 44%. Twelve hours after the combination, beta-blocking activity (as indicated by inhibition of exercise tachycardia) was reduced compared to that with atenolol alone. However, during a 4-week treatment in six hypertensive patients, there was no difference in blood pressure values between treatments. The investigators suggest that prolongation of the elimination half-life induced by calcium coadministration may have led to atenolol cumulation during long-term dosing, which compensated for the reduced bioavailability.

MANAGEMENT: It may help to separate the administration times of beta-blockers and calcium products by at least 2 hours. Patients should be monitored for potentially diminished beta-blocking effects following the addition of calcium therapy.

References
  • Kirch W, Schafer-Korting M, Axthelm T, Kohler H, Mutschler E "Interaction of atenolol with furosemide and calcium and aluminum salts." Clin Pharmacol Ther 30 (1981): 429-35
Calcium Carbonate Chewable Tablets (Antacid)

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

Inderal

Generic Name: propranolol

Brand name: Inderal LA, Inderal XL, InnoPran XL, Inderal, Hemangeol, InnoPran XL

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.