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InnoPran XL and Maalox

Determining the interaction of InnoPran XL and Maalox and the possibility of their joint administration.

Check result:
InnoPran XL <> Maalox
Relevance: 11.01.2023 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:

Concurrent administration with aluminum and magnesium antacids has been shown to decrease the oral bioavailability of certain beta-blockers, although data are conflicting. The exact mechanism of interaction is unknown but may involve cation binding of beta-blockers or a reduction in the dissolution rate due to increased gastric pH. In six healthy volunteers, concomitant administration of a single dose of antacid (magnesium hydroxide-aluminum oxide 1200 mg-1800 mg) reduced the peak plasma concentration (Cmax), area under the concentration-time curve (AUC) and 24-hour urinary excretion of sotalol (160 mg) by 27%, 21% and 9%, respectively, while administration of the antacid 2 hours after the sotalol dose produced no change. Pharmacodynamic data suggest that the negative chronotropic effect of sotalol was also reduced up to 4 hours after administration of the combination, although the lack of a placebo control might have confounded the results. In another study, concomitant administration of an aluminum hydroxide antacid in six healthy volunteers decreased atenolol (100 mg) Cmax and AUC by 37% and 33%, respectively. However, the Cmax and AUC of metoprolol (100 mg) in the same group was increased 25% and 11%, respectively, by administration of the antacid. Two other studies with aluminum hydroxide failed to find a significant effect on pharmacokinetics or pharmacodynamics of atenolol and propranolol. Based on available data, the clinical significance of this potential interaction is difficult to determine. As a precaution, patients may want to consider separating the administration times of beta-blockers and antacids or other aluminum- or magnesium-containing products by at least 2 hours.

References
  • D'Arcy PF, McElnay JC "Drug-antacid interactions: assessment of clinical importance." Drug Intell Clin Pharm 21 (1987): 607-17
  • Laer S, Neumann J, Scholz H "Interaction between sotalol and an antacid preparation." Br J Clin Pharmacol 43 (1997): 269-72
  • Gugler R, Allgayer H "Effects of antacids on the clinical pharmacokinetics of drugs. An update." Clin Pharmacokinet 18 (1990): 210-9
  • Kirch W, Schafer-Korting M, Axthelm T, Kohler H, Mutschler E "Interaction of atenolol with furosemide and calcium and aluminum salts." Clin Pharmacol Ther 30 (1981): 429-35
  • Regardh CG, Lundborg P, Persson BA "The effect of antacid, metoclopramide, and propantheline on the bioavailability of metoprolol and atenolol." Biopharm Drug Dispos 2 (1981): 79-87
  • Dobbs JH, Skoutakis VA, Acchiardo SR, Dobbs BR "Effects of aluminum hydroxide on the absorption of propranolol." Curr Ther Res Clin Exp 21 (1977): 887-92
  • Hong CY, Hu SC, Lin SJ, Chiang BN "Lack of influence of aluminum hydroxide on the bioavailability and beta-adrenoceptor blocking activity of propranolol." Int J Clin Pharmacol Ther Toxicol 23 (1985): 244-6
InnoPran XL

Generic Name: propranolol

Brand name: Hemangeol, Inderal LA, Inderal XL, InnoPran XL, Inderal, InnoPran XL

Synonyms: n.a.

Maalox

Generic Name: aluminum hydroxide / magnesium hydroxide

Brand name: Alamag

Synonyms: Aluminum Hydroxide and Magnesium Hydroxide Chewable Tablets

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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