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Flintstones Toddler and Viokace

Determining the interaction of Flintstones Toddler and Viokace and the possibility of their joint administration.

Check result:
Flintstones Toddler <> Viokace
Relevance: 17.02.2023 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:

Pancrelipase may reduce the effectiveness of folic acid and iron by interfering with their absorption. To prevent or minimize the interaction, you should separate the dosing times of pancrelipase and any product containing folic acid or iron by as much as possible. 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:

MONITOR: Exogenous pancreatic enzymes may interfere with the gastrointestinal absorption of folic acid and iron. The exact mechanism of interaction is unknown. In one study, investigators compared oral iron absorption over a 3-hour period in the presence and absence of exogenous pancreatic enzymes in 13 stable young adults with cystic fibrosis and 9 age-matched controls. There was no difference between patients and controls in iron absorption in the absence of exogenous pancreatic enzymes. However, significant impairment of iron absorption was observed in both groups after administration of pancrelipase one hour prior to iron administration. In the patient group, one hour after iron administration, there was a 188% increase in serum iron level above baseline in the absence of pancrelipase but only a 62% increase in the presence of pancrelipase. In the controls, percentage increases as well as peak serum iron levels were significantly higher in the absence of pancrelipase during all 3 hours after iron administration. Clinically, at least one-third of cystic fibrosis patients reportedly have iron deficiency. In the study, mean serum iron concentration was significantly lower in patients than in controls (11.9 versus 18.9 micromoles/L), and 5 of the patients but none of the controls had a serum iron concentration lower than 9 micromoles/L at baseline, presumably due to long-term treatment with pancreatic enzyme supplements.

MANAGEMENT: Patients receiving therapeutic iron or folate therapy should be monitored for potentially reduced hematologic response if pancreatic enzymes are administered concomitantly. Separating the times of administration may be helpful.

References
  • Zempsky WT, Rosenstein BJ, Carroll JA, Oski FA "Effect of pancreatic enzyme supplements on iron absorption." Am J Dis Child 143 (1989): 969-72
  • "Product Information. L-Methylfolate Calcium (l-methylfolate)." Virtus Pharmaceuticals LLC, Tampa, FL.
  • Dietze F, Bruschke G "Inhibition of iron absorption by pancreatic extracts." Lancet 1 (1970): 424
  • "Product Information. Cotazym (pancrelipase)." Organon, West Orange, NJ.
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

Viokace

Generic Name: pancrelipase

Brand name: Creon, Pancreaze, Pertzye, Ultresa, Viokace, Zenpep, Cotazym, Viokase, Zymase, Pancrease MT 4, Pancrease MT 16, Protilase, Panase, Ku-Zyme HP, Cotazym-S, Creon 10, Creon 20, Ultrase MT 20, Protilase MT-16, Creon 5, Pancrease, Pancrease MT 10, Vio-Moore, Panokase, Ilozyme, Pancrease MT 20, Ultrase, Ultrase MT 12, Pancron D/R, Encron-10, Ultrase MT 18, Arco-Lase, Lipram, Pancrecarb MS-8, Pancrecarb MS-4, Lipram-UL 18, Lipram-CR20, Lipram-UL 12, Lipram-UL 20, Viokase 16, Pancreatil-UL 12, Pangestyme CN 10, Pangestyme CN 20, Pangestyme MT 16, Pangestyme UL 18, Pangestyme EC, Kutrase, Ku-Zyme, Lipram-CR, Plaretase, Viokase 8, Lipram-CR5, Lapase, Dygase, Pancrecarb MS-16, Pangestyme UL 20, Panocaps, Panocaps MT 16, Lipram-CR10, Palcaps 10, Lipram-PN10, Lipram-PN16, Lipram-PN20, Panokase 16

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.

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