Ex-Lax Milk of Magnesia and Raltegravir Powder for Oral Suspension

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.

Magnesium hydroxide can interfere with the absorption of raltegravir, even if they are not taken at the same time. This may reduce the blood levels of raltegravir, which may make the medication less effective in treating HIV infection. You should avoid taking magnesium hydroxide or other aluminum- or magnesium-containing antacids during treatment with raltegravir. Talk to a health care provider if you have any questions or concerns. Your doctor or pharmacist may be able to recommend alternatives that do not interact with raltegravir. 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.

GENERALLY AVOID: Coadministration with aluminum- and/or magnesium-containing antacids may reduce the oral bioavailability of raltegravir. The proposed mechanism is chelation of raltegravir by polyvalent cations, but changes in solubility and lipophilicity of raltegravir related to pH increases may also contribute. In drug interaction studies, raltegravir peak plasma concentration (Cmax), systemic exposure (AUC) and trough plasma concentration (Cmin) decreased by 44%, 49% and 63%, respectively, when a single 20 mL dose of aluminum and magnesium hydroxide antacid was administered simultaneously with raltegravir (400 mg twice daily). The Cmax, AUC and Cmin of raltegravir decreased by 51%, 51% and 56%, respectively, when the antacid was given 2 hours before raltegravir, and by 22%, 30% and 57%, respectively, when the antacid was given 2 hours after raltegravir. When given 4 hours apart, raltegravir Cmax, AUC and Cmin decreased by 22%, 19% and 60% with antacid administered first, and by 30%, 32% and 62% with raltegravir administered first. Minimal changes in raltegravir Cmax and AUC were observed when administration was staggered by 6 hours; however Cmin was still diminished by approximately 50% regardless of whether antacid was administered before or after raltegravir. When given with a single dose of antacid containing calcium carbonate 3000 mg, raltegravir Cmax, AUC and Cmin decreased by 52%, 55% and 32%, respectively. These changes are not considered clinically significant by the manufacturer.

MANAGEMENT: Concomitant use of raltegravir with aluminum- and/or magnesium-containing antacids should generally be avoided, even if administration is staggered. Antacids containing calcium carbonate may be used without dose adjustment for raltegravir.

Ex-Lax Milk of Magnesia

Generic Name: magnesium hydroxide

Brand name: Ex-Lax Milk of Magnesia, Milk of Magnesia, Pedia-Lax Chewable, Phillips Milk of Magnesia, Dulcolax Milk of Magnesia, Concentrated Phillips Milk of Magnesia

Synonyms: n.a.

What is Ex-Lax Milk of Magnesia?

Raltegravir Powder for Oral Suspension

Generic Name: raltegravir

Brand name: Isentress, Isentress HD

Synonyms: Raltegravir

What is Raltegravir Powder for Oral Suspension?