Pediatric Multivitamin Chewables with Iron and Sinemet 25-100
Determining the interaction of Pediatric Multivitamin Chewables with Iron and Sinemet 25-100 and the possibility of their joint administration.
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:Levodopa and multivitamin with iron should not be taken orally at the same time. Products that contain iron may interfere with the absorption of levodopa and reduce its effectiveness. You should separate the dosing of these medications by as much as possible. Contact your doctor if your Parkinson symptoms worsen. 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:ADJUST DOSING INTERVAL: The oral bioavailability and pharmacologic effects of levodopa and carbidopa may be decreased during concurrent administration with iron-containing products. The proposed mechanism is chelation of levodopa and carbidopa by the iron cation, forming an insoluble complex that is poorly absorbed from the gastrointestinal tract. In nine patients with Parkinson's disease, administration of levodopa-carbidopa 100 mg-25 mg with ferrous sulfate 325 mg decreased levodopa peak plasma concentration (Cmax) and systemic exposure (AUC) by 47% and 30%, respectively, and carbidopa Cmax and AUC by 77% and 82%, respectively, compared to administration with placebo. There was also evidence of reduced efficacy of levodopa in some patients. In another study consisting of eight healthy subjects, coadministration of levodopa 250 mg with ferrous sulfate 325 mg resulted in greater than 50% reductions in the Cmax and AUC of levodopa compared to administration of levodopa alone. The magnitude of the interaction was the greatest in patients whose plasma levels of levodopa were the highest following administration of levodopa alone.
MANAGEMENT: Until more information is available, patients receiving levodopa and/or carbidopa in combination with iron-containing products should be advised to separate the times of administration by as much as possible. Patients should be monitored for reduced efficacy of levodopa, and the dosage adjusted as necessary.
- Campbell NR, Hasinoff BB "Iron supplements: a common cause of drug interactions." Br J Clin Pharmacol 31 (1991): 251-5
- Greene RJ, Hall AD, Hider RC "The interaction of orally administered iron with levodopa and methyldopa therapy." J Pharm Pharmacol 42 (1990): 502-4
- Campbell NR, Hasinoff B "Ferrous sulfate reduces levodopa bioavailability: chelation as a possible mechanism." Clin Pharmacol Ther 45 (1989): 220-5
- Campbell NR, Rankine D, Goodridge AE, Hasinoff BB, Kara M "Sinemet-ferrous sulphate interaction in patients with Parkinson's disease." Br J Clin Pharmacol 30 (1990): 599-605
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
Generic Name: carbidopa / levodopa
Brand name: Parcopa, Rytary, Sinemet, Sinemet CR, Duopa
Synonyms: Carbidopa and levodopa, Carbidopa and Levodopa
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.
- Pediatric Multivitamin Chewables with Iron-Sinemet 25-250
- Pediatric Multivitamin Chewables with Iron-Sinemet 250/25
- Pediatric Multivitamin Chewables with Iron-Sinemet CR
- Pediatric Multivitamin Chewables with Iron-Sinemet CR 100/25
- Pediatric Multivitamin Chewables with Iron-Sinemet CR 200/50
- Pediatric Multivitamin Chewables with Iron-Sinequan
- Sinemet 25-100-Pediatric Multivitamin Drops
- Sinemet 25-100-Pediatric Multivitamin Drops with Fluoride
- Sinemet 25-100-Pediatric Multivitamin Drops with Fluoride and Iron
- Sinemet 25-100-Pediatric Multivitamin Drops with Iron
- Sinemet 25-100-Pediatric Multivitamin Liquid
- Sinemet 25-100-Pediatric Multivitamin Liquid with Iron