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Duopa and Marnatal-F

Determining the interaction of Duopa and Marnatal-F and the possibility of their joint administration.

Check result:

Duopa <> Marnatal-F

Relevance: 07.05.2022 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:

Levodopa and multivitamin, prenatal should not be taken orally at the same time. Products that contain iron may interfere with the absorption of levodopa and reduce its effectiveness. You should separate the dosing of these medications by as much as possible. Contact your doctor if your Parkinson symptoms worsen. 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 oral bioavailability and pharmacologic effects of levodopa and carbidopa may be decreased during concurrent administration with iron-containing products. The proposed mechanism is chelation of levodopa and carbidopa by the iron cation, forming an insoluble complex that is poorly absorbed from the gastrointestinal tract. In nine patients with Parkinson's disease, administration of levodopa-carbidopa 100 mg-25 mg with ferrous sulfate 325 mg decreased levodopa peak plasma concentration (Cmax) and systemic exposure (AUC) by 47% and 30%, respectively, and carbidopa Cmax and AUC by 77% and 82%, respectively, compared to administration with placebo. There was also evidence of reduced efficacy of levodopa in some patients. In another study consisting of eight healthy subjects, coadministration of levodopa 250 mg with ferrous sulfate 325 mg resulted in greater than 50% reductions in the Cmax and AUC of levodopa compared to administration of levodopa alone. The magnitude of the interaction was the greatest in patients whose plasma levels of levodopa were the highest following administration of levodopa alone.

MANAGEMENT: Until more information is available, patients receiving levodopa and/or carbidopa in combination with iron-containing products should be advised to separate the times of administration by as much as possible. Patients should be monitored for reduced efficacy of levodopa, and the dosage adjusted as necessary.

References

Campbell NR, Hasinoff BB "Iron supplements: a common cause of drug interactions." Br J Clin Pharmacol 31 (1991): 251-5
Greene RJ, Hall AD, Hider RC "The interaction of orally administered iron with levodopa and methyldopa therapy." J Pharm Pharmacol 42 (1990): 502-4
Campbell NR, Hasinoff B "Ferrous sulfate reduces levodopa bioavailability: chelation as a possible mechanism." Clin Pharmacol Ther 45 (1989): 220-5
Campbell NR, Rankine D, Goodridge AE, Hasinoff BB, Kara M "Sinemet-ferrous sulphate interaction in patients with Parkinson's disease." Br J Clin Pharmacol 30 (1990): 599-605

Duopa

Generic Name: carbidopa / levodopa

Brand name: Duopa, Parcopa, Rytary, Sinemet, Sinemet CR

Synonyms: n.a.

What is Duopa?

Marnatal-F

Generic Name: multivitamin, prenatal

Brand name: NataChew, Select-OB, A-Free Prenatal, Azesco, CitraNatal 90 DHA, CitraNatal Assure, CitraNatal B-Calm, Materna, Pramilet FA, Stuartnatal Plus, Natalins Rx, Norlac RX, Neo-Forte, Mynatal, Zenate Advanced Formula, Prenatal MR 90, O-Cal-FA, Equi-Natal Plus, Pan OB Forte, Hi-Nate 90, Lactocal-F, Maternity-90, Prenazyme 1+1, Pre-H-Cal, Femnatal, Vynatal 1 Plus 1, Par-F, Maternity, Niferex PN Forte, Prenavite, Mynatal PN, Obnate 90, Maternal 90, Mynatal Rx, PreCare, Natarex, Ternamar, Aminatal Plus, Elemental Iron-90, Mynatal PN Forte, Mynatal FC, Mynate 90 Plus, Vitamed Prenatal Formula, Zitamin, Preterna, Vernate, Vernate Advanced, Prenate 90, Aminate, Mission Prenatal Rx, Niferex-PN, Marnatal-F, Prenate Ultra, Prenatal Z Advanced Formula, Prenatal Plus, Zenate Prenatal, NatalCare, Prenatal Plus with Beta-Carotene, Prenatal Rx, Maternity plus Beta Carotene, Equi-Natal M, Equi-Natal Rx, Equinatal 90, Equi-Natal Z, Natalcare Pic Forte, Natalcare Pic, Natalins, Stuart Prenatal with Beta Carotene, Prenatal MR 90 Fe, Aminatal Plus One, Aminate with 90 mg Iron, Ultra NatalCare, Prenatal S, Natafort, Nestabs, Nestabs CBF, Vitafol PN, Fem-Natal, Ami-Natal Plus One Improved, Aminatal Plus New Formula, Prenatal Plus with 27 mg Iron, Obegyn, Mission Prenatal, Mission Prenatal FA, Mission Prenatal HP, Mynatal Z, Mynatal Plus, Mynatal Ultracap, Prenatal Plus Iron, Prenatal 1 Plus 1, Natalcare Plus, Prenatal MTR with Selenium, Natalcare Rx, Prenavite FC, Prenavite PC, Chromagen OB, Natatab CFe, Natatab FA, Vitelle Nestabs OTC, NataChew, Premesis Rx, Prenate Advanced Formula, Precare Conceive, Citracal Prenatal Rx, Advanced NatalCare, NutriNate, Nestabs Rx, Stuartnatal Plus 3, Strongstart, Anemagen OB, Ultra-Natal, NatalCare Three, Natatab Rx, Equi-Natal Care, Inatal Advance, Inatal Ultra, Maternity Vitamin Low Iron, Ob-20, Prenatabs CBF, Prenatal Rx Low Iron, Vinate 90, Vinate M, Vinate Ultra, Prenate GT, Ferrex PC Forte, Trinate, Prenatal AD, Prenatal 19, Natalcare, Prenatal H, Duet Chewable, Natalfirst, Natelle, Cenogen Ultra, Prenatal-U, Nestabs FA, Vinate GT, Natafolic-PN, Cal-Nate, Icar Prenatal, Prenate Advance, Novastart, Novanatal, Natacaps, O-Cal Prenatal, NatalCare Advanced-RF, Duet DHA, Prenatabs OBN, Icare Prenatal Rx, Vinatal 600, Nutrispire, PrimaCare One, PrenaFirst, Natafolic-OB, , Choice-OB+DHA, Select-OB+DHA, Stuart One

Synonyms: n.a.

What is Marnatal-F?

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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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