Antacids (Tums, Maalox, Mylanta) interactions

Routine administration of BIXLENVO together with, or 2 hours after, antacids containing Al/Mg is not recommended. (Bictegravir, emtricitabine, and tenofovir alafenamide label, Drug interactions)

…change in bowel habits that lasts more than 2 weeks stomach pain, nausea or vomiting When using this product do not chew or crush tablet(s) do not use within 1 hour after taking an antacid or milk it may cause stomach discomfort, faintness, and cramps Stop use and ask a doctor if you have rectal bleeding or fail to have a bowel movement after use of a laxative. (Bisacodyl label, Warnings)

Magnesium-containing preparations (e.g., antacids) and calcitriol should not be used concomitantly in patients on chronic renal dialysis because such use may lead to the development of hypermagnesemia. (Calcitriol label, Warnings)

Do not take Exjade with aluminum-containing antacid preparations. (Deferasirox label, Drug interactions)

Effect of Antacids Because antacids may interfere with the absorption of anticholinergic agents including dicyclomine hydrochloride, simultaneous use of these drugs should be avoided. (Dicyclomine label, Drug interactions)

When using this product do not take more than directed do not take at the same time as aluminum or magnesium antacids do not take with fruit juices (see Directions) Stop use and ask a doctor if an allergic reaction to this product occurs. (Fexofenadine label, Warnings)

Antacids Because the dissolution of the coating of the granules in APRISO capsules depends on pH, avoid co-administration of APRISO capsules with antacids [see Dosage and Administration (2) ] . (Mesalamine label, Drug interactions)

Intervention: Concomitant administration of antacids such as magnesium oxide or aluminum hydroxide, and sucralfate with Naproxen Suspension is not recommended. (Naproxen label, Drug interactions)

If coadministration of nitrofurantoin with antacids containing magnesium trisilicate cannot be avoided, monitor for lack of efficacy [see Clinical Pharmacology (12.3) ]. (Nitrofurantoin label, Drug interactions)

• that mineral supplements, vitamins with iron or minerals, calcium-, aluminum- or magnesium-based antacids, sucralfate or didanosine chewable/buffered tablets or the pediatric powder for oral solution should not be taken within the two-hour period before or within the two-hour period after taking ofloxacin (see Drug Interactions ) • that ofloxacin can be taken… (Ofloxacin label, Precautions)

Calcium carbonate, aluminum hydroxide, magnesium hydroxide Prevention or Management: Phenytoin and antacids should not be taken at the same time of day Antineoplastic agents (usually in combination) Bleomycin, carboplatin, cisplatin, doxorubicin, methotrexate Antiviral agents Fosamprenavir, nelfinavir, ritonavir Antiepileptic drugs Carbamazepine, vigabatrin Other… (Phenytoin label, Drug interactions)

Quinine Prevention or Management: Avoid concomitant use Decrease AUC by 75%–85% Telithromycin Decrease AUC by 86% Theophylline Decrease exposure by 20% to 40% Effect of Other Drugs on Rifampin Concomitant antacid administration may reduce the absorption of rifampin. (Rifampin label, Drug interactions)

Antacids: Antacids such as aluminum hydroxide/magnesium hydroxide decrease riociguat absorption and should not be taken within 1 hour of taking Adempas [see Clinical Pharmacology (12.3) ]. (Riociguat label, Drug interactions)

Calcium supplements, antacids, magnesium-based supplements or laxatives, and iron preparations interfere with the absorption of Risedronate sodium delayed-release and should not be taken together. (Risedronate label, Drug interactions)

Alkalinizing agents (GI antacids and urinary): These agents increase blood levels of amphetamine. (Amphetamine and dextroamphetamine label, Drug interactions)

Drug Interactions: Antacids (Aluminum- or Magnesium-Containing): Concomitant administration of 300 mg cefdinir capsules with 30 mL Maalox ® TC suspension reduces the rate (C max ) and extent (AUC) of absorption by approximately 40%. (Cefdinir label, Drug interactions)

Drug Interactions Antacids Concomitant administration of high doses of antacids (sodium bicarbonate and aluminum hydroxide) or H 2 blockers reduces peak plasma levels by 24% to 42% and the extent of absorption by 27% to 32%, respectively. (Cefpodoxime label, Drug interactions)

Drug Interactions Antacids and kaolin: Antacids and kaolin can reduce absorption of chloroquine; an interval of at least 4 hours between intake of these agents and chloroquine should be observed. (Chloroquine label, Drug interactions)

Drug(s) Affecting Pharmacokinetics of Ciprofloxacin Antacids, Sucralfate, Multivitamins and Other Products Containing Multivalent Cations (magnesium/aluminum antacids; polymeric phosphate binders (for example, sevelamer, lanthanum carbonate); sucralfate; Videx ® (didanosine) chewable/buffered tablets or pediatric powder; other highly buffered drugs; or products… (Ciprofloxacin label, Drug interactions)

Digoxin Concentrations Decreased Acarbose, Activated Charcoal, Albuterol, Antacids, certain cancer chemotherapy or radiation therapy, Cholestyramine, Colestipol, Exenatide, Kaolin-pectin, Meals High in Bran, Metoclopramide, Miglitol, Neomycin, Penicillamine, Phenytoin, Rifampin, St. (Digoxin label, Drug interactions)

However, antacids can decrease the peak concentration reached by 15% to 20% but have no detectable effect on the time-to-peak. (Etodolac label, Drug interactions)

Antacids In a clinical pharmacology study, coadministration of an antacid (aluminum hydroxide, magnesium hydroxide, and simethicone) with fosinopril reduced serum levels and urinary excretion of fosinoprilat as compared with fosinopril administrated alone, suggesting that antacids may impair absorption of fosinopril. (Fosinopril label, Drug interactions)

Maalox ® (aluminum hydroxide, magnesium hydroxide) The mean bioavailability of gabapentin was reduced by about 20% with concomitant use of an antacid (Maalox ® ) containing magnesium and aluminum hydroxides. (Gabapentin label, Drug interactions)

Antacids and kaolin Antacids and kaolin can reduce absorption of chloroquine; an interval of at least 4 hours between intake of these agents and chloroquine should be observed. (Hydroxychloroquine label, Drug interactions)

Gastrointestinal Drugs Drugs that reduce gastric acidity e.g. acid neutralizing medicines such as aluminum hydroxide, or acid secretion suppressors such as H 2 - receptor antagonists and proton pump inhibitors (e.g., omeprazole). (Itraconazole label, Drug interactions)

Drugs that may decrease ketoconazole plasma concentrations Drugs that reduce the gastric acidity (e.g., acid neutralizing medicines such as aluminum hydroxide, or acid secretion suppressors such as H 2 -receptor antagonists and proton pump inhibitors) impair the absorption of ketoconazole from ketoconazole tablets. (Ketoconazole label, Drug interactions)

Interacting Drug Interaction Multivalent cation-containing products including antacids, metal cations or didanosine Absorption of levofloxacin is decreased when the tablet or oral solution formulation is taken within 2 hours of these products. (Levofloxacin label, Drug interactions)

See FPI for drugs that may interfere with systemic exposure and reduce MYHIBBIN efficacy: antacids with magnesium or aluminum hydroxide, proton pump inhibitors, drugs that interfere with enterohepatic recirculation, telmisartan, calcium-free phosphate binders. (Mycophenolate label, Drug interactions)

Table 6: Drug Interactions that Decrease the Efficacy of CRESTOR Antacids Prevention or Management: In patients taking an antacid, administer CRESTOR at least 2 hours before the antacid . (Rosuvastatin label, Drug interactions)

Antacids (e.g., aluminum and magnesium hydroxide) Separate antacid and VOSEVI administration by 4 hours. (Sofosbuvir and velpatasvir label, Drug interactions)

Other drugs, such as: Magnesium and aluminum hydroxide antacids Metoclopramide May increase tacrolimus whole blood trough concentrations and increase the risk of serious adverse reactions (e.g., neurotoxicity, QT prolongation) [see Warnings and Precautions ( 5.7 , 5.10 , 5.11 )]. (Tacrolimus label, Drug interactions)

Antacids — Simultaneous administration of an antacid (magnesium hydroxide/aluminum hydroxide) and tadalafil reduced the apparent rate of absorption of tadalafil without altering exposure (AUC) to tadalafil. (Tadalafil label, Drug interactions)

Exposure to trospium on average was comparable in the presence of and without antacid, however, some individuals demonstrated increases or decreases in trospium exposure in the presence of antacid. (Trospium label, Drug interactions)

Calcium supplements, antacids or oral medications containing multivalent cations interfere with absorption of alendronate. (Alendronate label, Drug interactions)

Administer cefuroxime axetil at least 1 hour before or 2 hours after administration of short-acting antacids. (Cefuroxime label, Drug interactions)

Antacids Diazepam peak concentrations are 30% lower when antacids are administered concurrently. (Diazepam label, Drug interactions)

TIVICAY or TIVICAY PD should be taken 2 hours before or 6 hours after taking cation-containing antacids or laxatives, sucralfate, oral supplements containing iron or calcium, or buffered medications. (Dolutegravir label, Drug interactions)

Absorption of tetracyclines, including doxycycline hyclate is impaired by antacids containing aluminum, calcium, or magnesium, bismuth subsalicylate and iron-containing preparations. (Doxycycline label, Drug interactions)

Drug interactions may occur when anticholinergics are used with the following medications: antacids, antidiarrheals (adsorbent), other anticholinergics, antimyasthenics, cyclopropane, haloperidol, ketoconazole, metoclopramide, opioid (narcotic) analgesics, and potassium chloride. (Hyoscyamine label, Drug interactions)

Calcium supplements, antacids and some oral medications may interfere with absorption of ibandronate. (Ibandronate label, Drug interactions)

Drug Interactions Results of preliminary studies in humans and rats suggest that nonabsorbable antacids given concurrently with lactulose may inhibit the desired lactulose-induced drop in colonic pH. (Lactulose label, Drug interactions)

Antacids and Iron Preparations Absorption of tetracyclines is impaired by antacids containing aluminum, calcium or magnesium and iron-containing preparations. (Minocycline label, Drug interactions)

Other Concomitant Medications EVISTA can be concomitantly administered with ampicillin, amoxicillin, antacids, corticosteroids, and digoxin [see Clinical Pharmacology ( 12.3 )] . (Raloxifene label, Drug interactions)

Absorption of tetracyclines is impaired by antacids containing aluminum, calcium or magnesium and preparations containing iron, zinc, or sodium bicarbonate. (Tetracycline label, Drug interactions)

Aluminum-based Antacids : May interfere with the action of URSO 250 and URSO Forte by reducing its absorption. (Ursodiol label, Drug interactions)

Other Drug Interactions No pharmacokinetic interactions were observed between vardenafil and the following drugs: glyburide, warfarin, digoxin, an antacid based on magnesium-aluminum hydroxide, and ranitidine. (Vardenafil label, Drug interactions)

If a patient requires dofetilide and anti-ulcer therapy, it is suggested that omeprazole, ranitidine, or antacids (aluminum and magnesium hydroxides) be used as alternatives to cimetidine, as these agents have no effect on the pharmacokinetic profile of dofetilide. (Dofetilide label, Drug interactions)

However, co-administration of CYMBALTA with aluminum- and magnesium-containing antacids (51 mEq) or CYMBALTA with famotidine, had no significant effect on the rate or extent of duloxetine absorption after administration of a 40 mg oral dose. (Duloxetine label, Drug interactions)

…Penciclovir No clinically significant alterations in penciclovir pharmacokinetics were observed following single-dose administration of 500 mg famciclovir after pretreatment with multiple doses of allopurinol, cimetidine, theophylline, zidovudine, promethazine, when given shortly after an antacid (magnesium and aluminum hydroxide), or concomitantly with emtricitabine. (Famciclovir label, Drug interactions)

Effects of Antacids on Felbatol ® The rate and extent of absorption of a 2400 mg dose of Felbatol ® as monotherapy given as tablets was not affected when coadministered with antacids. (Felbamate label, Drug interactions)

Concomitant administration of an aluminum-containing antacid had no significant effect on the bioavailability of 6MNA. (Nabumetone label, Drug interactions)

Cimetidine and Antacids — Single doses of cimetidine (800 mg) or aluminum- and magnesium-containing antacids did not affect the oral bioavailability of olanzapine. (Olanzapine label, Drug interactions)

…Clinically Significant Drug Interaction with TAMIFLU No dose adjustments are needed for either oseltamivir or the concomitant drug when coadministering oseltamivir with amoxicillin, acetaminophen, aspirin, cimetidine, antacids (magnesium and aluminum hydroxides and calcium carbonates), rimantadine, amantadine, or warfarin [see Clinical Pharmacology (12.3) ] . (Oseltamivir label, Drug interactions)

No clinically relevant effects on the pharmacokinetics of Noxafil delayed-release tablets were observed during concomitant use with antacids, H 2 -receptor antagonists and proton pump inhibitors, and metoclopramide [see Clinical Pharmacology (12.3) ] . (Posaconazole label, Drug interactions)

Drugs for which either no interaction or a likely clinically unimportant interaction has been observed Antacids A study involving the co-administration of valproate 500 mg with commonly administered antacids (Maalox, Trisogel, and Titralac - 160 mEq doses) did not reveal any effect on the extent of absorption of valproate. (Valproic acid label, Drug interactions)

Antacid The co-administration of 30 mL of Maalox ® with ziprasidone did not affect the pharmacokinetics of ziprasidone. (Ziprasidone label, Drug interactions)