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Caltrate 600+D Soft Chews and Cuprimine

Determining the interaction of Caltrate 600+D Soft Chews and Cuprimine and the possibility of their joint administration.

Check result:
Caltrate 600+D Soft Chews <> Cuprimine
Relevance: 06.06.2023 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:

PenicillAMINE and calcium carbonate should not be taken orally at the same time. Products that contain magnesium, aluminum, calcium, iron, and/or other minerals may interfere with the absorption of penicillAMINE into the bloodstream and reduce its effectiveness. You should take calcium carbonate at least 2 hours before or 2 hours after the penicillAMINE dose. Talk to a healthcare professional if you are not sure whether a product contains something that could potentially interact with your medication or if you have questions on how to take this or other medications you are prescribed. 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: Oral administration of aluminum, copper, iron, zinc, magnesium, and possibly other minerals such as calcium may decrease the gastrointestinal absorption of penicillamine, and vice versa. The proposed mechanism involves chelation of penicillamine to polyvalent cations, which leads to formation of a nonabsorbable complex. In a study of six healthy volunteers, administration of penicillamine (500 mg) following a single dose of ferrous sulfate (300 mg) or antacid (Maalox Plus 30 mL) reduced the mean peak plasma concentration of penicillamine by 65% and 34%, respectively, compared to administration in the fasting state. In addition to chelation, some investigators suggest that antacids may also reduce penicillamine bioavailability by increasing gastric pH, which favors the oxidation of penicillamine to its poorly absorbed disulfide form. These changes could result in diminished therapeutic effects of penicillamine.

MANAGEMENT: Mineral supplements or other products containing polyvalent cations (e.g., antacids or preparations containing antacids such as didanosine buffered tablets or pediatric oral solution) should be administered at least two hours before or two hours after the penicillamine dose. In addition, pharmacologic response to penicillamine should be monitored more closely whenever these products are added to or withdrawn from therapy, and the penicillamine dosage adjusted as necessary.

References
  • Lyle WH "Penicillamine and iron." Lancet 2 (1976): 420
  • Haagsma CJ "Clinically important drug interactions with disease-modifying antirheumatic drugs." Drugs Aging 13 (1998): 281-9
  • Netter P, Bannwarth B, Pere P, Nicolas A "Clinical pharmacokinetics of D-penicillamine." Clin Pharmacokinet 13 (1987): 317-33
  • "Product Information. Cuprimine (penicillamine)." Merck & Co, Inc, West Point, PA.
  • Osman MA, Patel RB, Schuna A, Sundstrom WR, Welling PG "Reduction in oral penicillamine absorption by food, antacid and ferrous sulfate." Clin Pharmacol Ther 33 (1983): 465-70
  • Joyce DA "D-penicillamine pharmacokinetics and pharmacodynamics in man." Pharmacol Ther 42 (1989): 405-27
  • Harkness JA, Blake DR "Penicillamine nephropathy and iron." Lancet 2 (1982): 1368-9
Caltrate 600+D Soft Chews

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: n.a.

Cuprimine

Generic Name: penicillamine

Brand name: Cuprimine, Depen, D-Penamine, Depen Titratabs

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.

Interaction with food and lifestyle
Disease interaction