Flintstones Toddler and Nexium (Esomeprazole Delayed-Release Capsules)

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.

If you are iron-deficient or have anemia, you should talk to your doctor before using multivitamin with iron together with esomeprazole. By reducing stomach acid, esomeprazole may reduce the absorption of iron and make multivitamin with iron less effective in treating your condition. Your doctor or pharmacist may be able to offer suggestions on safer alternatives if you require treatment for stomach acid or ulcer while you are being treated with multivitamin with iron. 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.

MONITOR: The profound hypochlorhydria induced by proton pump inhibitors (PPIs) may impair the gastrointestinal absorption of nonheme iron, a process that is dependent on an acidic environment. The interaction was suspected in two patients with iron deficiency anemia due to gastrointestinal blood loss that were unresponsive to oral iron replacement therapy, even after the bleeding had apparently stopped. Both patients had been on omeprazole for six months while being treated with ferrous sulfate. An iron-loading test was performed on one of the patients and indicated iron malabsorption. Within two months after discontinuation of omeprazole, notable improvements in hemoglobin level and mean corpuscular volume (MCV) were observed in both patients, and iron absorption was significantly increased in the patient who underwent absorption testing. In a case review of patients with hereditary hemochromatosis treated at one institution, investigators observed a reduced requirement for maintenance phlebotomy in seven patients following initiation of PPI therapy (mean 2.5 L blood removed/year before PPI therapy vs. 0.5 L/year during PPI therapy), presumably due to reduced tissue iron accumulation stemming from impaired absorption of dietary nonheme iron. Mean annual phlebotomy requirement during PPI therapy in these patients was also lower than that in controls who had never taken a PPI (mean 2.3 L blood removed/year). The same group of investigators also studied iron absorption in 14 patients fed an iron-loaded meal before and after PPI therapy for one week. PPI therapy was associated with a 51% reduction in area under the serum iron concentration-time curve (AUC 0 to 4 hours); a 55% reduction in maximum increase of serum iron following ingestion of iron-loaded meal; and a 46% reduction in percent recovery of administered iron at peak serum iron concentration. Interestingly, the interaction has not been reported in healthy, iron-replete individuals. In a study of 109 patients with Zollinger-Ellison syndrome who had not undergone gastric resection, omeprazole treatment for an average of 5.7 years did not significantly decrease body iron stores or cause iron deficiency compared to H2-receptor antagonist therapy or no gastric acid-suppressant treatment. It is possible that the interaction may not affect people with healthy iron stores because of compensation by dietary heme iron, which typically comprises only a small fraction of dietary iron but whose absorption is not dependent on gastrointestinal pH. In contrast, dietary heme iron alone may not be sufficient to restore normal iron balance in patients with anemia or those with defective regulatory mechanisms of iron absorption.

MANAGEMENT: Patients with iron deficiency may not respond adequately to oral iron replacement therapy during coadministration of proton pump inhibitors. If an interaction is suspected after ruling out other causes, it may be appropriate to discontinue the proton pump inhibitor or consider administering iron parenterally.

Flintstones Toddler

Generic Name: multivitamin with iron

Brand name: Fero-Folic 500, Theragran Hematinic, Ultra Enerforce

Synonyms: Multivitamin with iron, Polysaccharide-Iron Complex, Vitamin B12, and Folic Acid

What is Flintstones Toddler?

Nexium (Esomeprazole Delayed-Release Capsules)

Generic Name: esomeprazole

Brand name: Nexium, Esomeprazole Strontium, Nexium, NexIUM 24HR, Nexium IV

Synonyms: Nexium

What is Nexium (Esomeprazole Delayed-Release Capsules)?