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Hecoria and Os-Cal 500+D

Determining the interaction of Hecoria and Os-Cal 500+D and the possibility of their joint administration.

Check result:
Hecoria <> Os-Cal 500+D
Relevance: 09.04.2023 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:

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

Professional:

In vitro data suggest that the presence of antacids may reduce the bioavailability of tacrolimus. An in vitro study showed that tacrolimus incubated in 100 mL simulated gastric fluid with the equivalent of 500 mg of various antacids resulted in loss of tacrolimus, due presumably to a pH-mediated degradation of tacrolimus. Specifically, aluminum-magnesium hydroxide caused a 14% loss of tacrolimus in 24 hours, magnesium oxide caused a 98% loss in 12 hours, and calcium carbonate caused a 30% loss in 24 hours. In contrast, aluminum hydroxide gel caused an immediate 35% loss of tacrolimus (within 2 minutes) and no further loss for 24 hours, suggesting adsorption of tacrolimus. Whether these effects occur in vivo, and to what extent, are unknown. Sodium bicarbonate has been reported to cause widely variable trough plasma levels and reduced blood concentrations of tacrolimus when given close to the time of administration of tacrolimus. No other details were available in the report. However, in a single-dose study, administration of tacrolimus with aluminum-magnesium hydroxide in healthy volunteers resulted in a 10% and 21% increase (not decrease) in tacrolimus peak concentration (Cmax) and systemic exposure (AUC), respectively, compared to administration without aluminum-magnesium hydroxide.

References
  • Steeves M, Abdallah HY, Venkataramanan R, et al "In-vitro activation of a novel immunosuppressant, FK 506, and antacids." J Pharm Pharmacol 43 (1991): 574-7
Hecoria

Generic Name: tacrolimus

Brand name: Astagraf XL, Envarsus XR, Prograf, Hecoria

Synonyms: Hecoria (Oral)

Os-Cal 500+D

Generic Name: calcium / vitamin d

Brand name: Calcitrate, Caltrate 600+D, Os-Cal 500+D, Calcitrate with D, Caltrate 600+D Soft Chews, Citracal + D, Os-Cal Extra D3, Oystercal-D, UpCal D, Os-Cal 250 with D, Oysco D, Dical-D, Calcet, Oyster Shell Calcium with Vitamin D, O-Cal-D, Oyster-D, Oyst-Cal-D, Caltro with Vitamin D, Oysco 500 with D, Oysco D with Calcium, Os-Cal with D, Caltrate 600 with D, Calcarb with D, Posture-D H/P, Dical Captabs, Dicalphos plus D, Os-Cal 500 with D, Caltrate 600 with D Plus Soy, Caltrate Colon Health, Calvite P & D, Sedecal D, Chewable Calcium with Vitamin D, Osteocit D Plus, Os-Cal 500 + D, Citracal Petites, Citracal Creamy Bites, Citracal 250 mg + D, Calcio Del Mar, Citrus Calcium with Vitamin D, Calcium 600+D, Risacal-D, Liquid Calcium with Vitamin D, Citracal Maximum + D, Citracal Calcium + D Slow Release 1200, Citracal Calcium Gummies, Caltrate Gummy Bites, Super Calcium 600 + D3 400, Os-Cal Calcium+D3, Caltrate 600 + D, Citracal Regular, Calcet Petites, Calcium 500+D, D3 with Calcium, Os-Cal 500+Extra D Chewable

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.

Interaction with food and lifestyle
Disease interaction