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Escavite D and Hydrochlorothiazide and methyldopa

Determining the interaction of Escavite D and Hydrochlorothiazide and methyldopa and the possibility of their joint administration.

Check result:
Escavite D <> Hydrochlorothiazide and methyldopa
Relevance: 05.08.2023 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:

Methyldopa and multivitamin with iron and fluoride should not be taken orally at the same time. Products that contain iron may interfere with the absorption of methyldopa and reduce its effectiveness. You should separate the dosing of these medications by as much as possible. Talk to your doctor if you have any questions or concerns. 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 methyldopa may be decreased during concurrent administration with iron-containing products. The proposed mechanism is chelation of methyldopa by the iron cation, forming an insoluble complex that is poorly absorbed from the gastrointestinal tract. In one study, five hypertensive patients receiving chronic methyldopa therapy (250 mg to 1500 mg daily) all had elevated blood pressure following the addition of ferrous sulfate 325 mg three times daily for 2 weeks. The systolic pressure had increased by more than 15 mmHg in three of the patients and the diastolic pressure increased by more than 10 mmHg in two. Blood pressure returned to baseline within 7 days of discontinuing the iron. In 12 normal subjects, administration of methyldopa 500 mg with ferrous sulfate 325 mg or ferrous gluconate 600 mg resulted in an 88% and 79% reduction, respectively, in the renal excretion of unmetabolized, free methyldopa compared to administration of methyldopa alone. In another study, administration of ferrous sulfate simultaneously with methyldopa reduced the bioavailability of methyldopa by 83%, while administration one hour or two hours before methyldopa reduced its bioavailability by 55% and 42%, respectively.

MANAGEMENT: Until more information is available, patients receiving methyldopa in combination with iron-containing products should be advised to separate the times of administration by as much as possible. Patients should be monitored closely for altered hypertensive effect and methyldopa dosage increased as necessary. Selection of an alternative antihypertensive therapy may be necessary.

References
  • Campbell NR, Campbell RR, Hasinoff BB "Ferrous sulfate reduces methyldopa absorption: methyldopa: iron complex formation as a likely mechanism." Clin Invest Med 6 (1990): 329-32
  • Campbell N, Paddock V, Sundaram R "Alteration of methyldopa absorption, metabolism, and blood pressure control caused by ferrous sulfate and ferrous gluconate." Clin Pharmacol Ther 43 (1988): 381-6
  • Campbell NR, Hasinoff BB "Iron supplements: a common cause of drug interactions." Br J Clin Pharmacol 31 (1991): 251-5
Escavite D

Generic Name: multivitamin with iron and fluoride

Brand name: Escavite, Escavite D, Poly-Vi-Flor, MyKidz Iron FL, Poly-Vi-Flor with Iron, TL Fluorivitamin, Tri Vites with Fluoride and Iron, Becomject-100, MVI-12, NephPlex RX, Nephrocaps, B-Ject 100, Therobec, B-Plex, Formula B, Vitaplex, Tri-Vi-Sol, Vi-Daylin ADC, Nephro-Vite Rx, Lipogen, Lipotriad, Lipoflavonoid, Cholinoid, Liponol, Bee-Comp with C, Cholidase, Cota-B-Plex, 1000 BC, Neurodep, Neuroforte-Six, MVI. Pediatric, B-Plex Plus, Nephrolan Rx, Zymacap, Vi-Daylin, Poly-Vi-Sol, Dayalets, Sigtab, Therems, StressTabs, Allbee-C 800, Cefol, Cod Liver Oil, Daily Multiple Vitamins, Daily Vite, Protegra, Sesame St. Vitamins with Extra C, Surbex-T, Theragran, Superplex-T, Vi-Stress, Cod Liver Oil Mint, Animal Shape Vitamins, B-50 Complex, B-Complex 50, Vitamin B Complex 100, Balanced B-100, B-Stress, B-Scorbic, Bee with C, Children's Chewable Multivitamins, Balanced B-50, Balanced B-150, Unicap Capsule, Unicap Jr, Unicap, Optilets-500, Super Plenamins, Vitamins for Hair, Tab-A-Vite, One-A-Day Essentials, Essential Balance, Vi-Daylin Chewable, Sunkist Child Chewable with C, Sunkist Child Chewable, Poly-Vi-Sol Chewable, Fruity Chew, Poly-Vit Chew, Chewable-Vite, Flintstones Multivitamins, Bugs Bunny with Extra C, Flintstones with C Multivitamins, Bounty Bear Vitamins, Garfield Vitamins, Vi-Daylin Drops, Poly-Vi-Sol Drops, Baby Vitamin Drop, Vita Drop, Poly Vit Drops, MVC. SDV, Glutofac, Allbee-C, Nephro-Vite, Vitabee with C, Stress B with C, High Potency B+C, Farbee with C, Surbex with C, Super B Complex, Surbex, Vitamin B-50, Vitamin B-100, Vitamin B-100 T/R, Hexavitamin, Kenwood Therapeutic, Thera, Theravite, Thera-Plus, Oncovite, Beminal-500, High Potency B Complex with B12 and C, Super B-50, Super B-100 TD, Tri-Vit Drops, Stress Formula, One Tab Daily, Vitamin C, E, and Rose Hips, Scotts Emulsion, Stress Formula 600, Tri-Vit, B Complex 50, Mega B, Folgard, Apatate, T-Vites, High B Complex, Theragenerix, Cernevit, Cardiotek, Beminal, Beminal with C Fortis, Bugs Bunny Multiple Vitamins, Fletanol, Male Formula, Allbee with C, Prevital, Surbex Filmtab, T-BMP, Tender Age Vitamin ADC, Watkins Harvest, Foltx, Folgard Rx 22, Cernevit-12, Infuvite, Infuvite Pediatric, Diatx, Vitamin A, D, One-A-Day 50+, Thex Forte, Protegra Cardio, Vitamin Daily Liquid, Rena-Vite Rx, Renal Caps, Icar C, Renaphro, Cerefolin, Dialyvite Rx, Dialyvite 800, Vesselvite, Folbee Plus, Folbee, Folcaps, Combgen, Abidec, Unichem Multivitamin, Topfit Vitamin B Complex, Topfit Vitamin B Complex Forte, Vitamin B Compound Strong, Health Aid Multivitamin, Vitamins, Daflon, Essentiale, Jetepar, Neurobion, Vitamin A and D Concentrate, Centrum 8400, MVI. Adult, Nephronex, Animi-3, Foltrate, Cardiotek Rx, Folbic, Metanx, D-400 international units, Folbalin Plus, Folbalin, Multi Vits with Beta Carotene, Foltabs 800, Folgard Rx, B-Complex with B-12, FaBB, CerefolinNAC, Folamin, DexFol, One-A-Day Men's Health Formula, Rena-Vite, Equaline One Daily Essential, Daily-Vite Men's Formula, Folplex, Folmor, Zycose, Biotin Forte, Vigomar Forte, Vimar, Multi-Delyn, Foleve Plus, Folnate, Folnate Plus, Foleve, B 100 Complex, Renatabs, AllanTex, Cardiotek-Rx, NuFol, Folplex 22, Reno Caps, Ivites Rx, TL Gard, Vita-Respa, Folast, Triphrocaps, Enfolast-N, Enfolast, Neurpath-B, Triveen-CF, Rovin-CF, Vol-Care Rx, Nephrocaps QT, B-Complex SR, Apetigen, L-methylfolate Ca, Me-Cbl NAC, P-5-P, Me-Cbl, MTX Support, Menopause Relief with Lifenol, Vitacirc-B, Alz-Nac, Tri-Vita Drops, Poly-Vita Drops, Prostate 24, Apetex, Folastin, Folbee AR, Metafolbic, Metafolbic Plus, Foltanx, Virt-Vite Forte, Virt-Vite, Foltanx RF, Folbic RF, One Daily Multi-Essential, Flintstones Toddler, Full Spectrum B with C, Metafolbic Plus RF, PoDiaPN, Super Theravite-M, Nature's Bounty Hair Skin & Nails, Total B with C, Hair, Skin, & Nails Gummies, Concentrated Whole Food Multivitamin, Niva-Fol, Glycogenics, SeroSyn, Virt-Vite Plus, Rheumate, Folinic-Plus, Allbee Plus, Av-VITE FB Forte, Celebrate B-12, Virt-Gard, Mebolic, DEKAs Essential, Multi Vitamin+, Xyzbac, Nufola, Folika-T, Hylavite, K2 Plus D3, Dosoquin, VP-Vite Rx, Genicin Vita-S, Genicin Vita-Q, Zyvit, Folika-V, Tobakient, Renal Vitamin, Folic-K

Synonyms: n.a.

Hydrochlorothiazide and methyldopa

Generic Name: hydrochlorothiazide / methyldopa

Brand name: Aldoril 15, Aldoril 25, Aldoril D30, Aldoril D50

Synonyms: Methyldopa and Hydrochlorothiazide

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