Interactions : אינטראקציות

4.5 Interaction with other medicinal products and other forms of interaction

•   Iron preparations, parenteral iron.

•   Iron salts diminish the absorption of tetracyclines, Tetracycline antibiotics should be taken at least 2 hours before or 4 hours after taking the medicine.
•   Follow up is required when antibiotics are used: Concurrent administration of oral iron preparations may interfere with the oral absorption of some quinolone anti-infective agents (e.g., ciprofloxacin, norfloxacin, ofloxacin), resulting in decreased serum and urine concentrations of the quinolones, Therefore, oral iron preparations should not be ingested within one hour before or within four hours of a dose of an oral quinolone. As well as for penicillin, chloramphenicol.
•   Thyroid hormones: Oral iron reduces the absorption of levothyroxine (thyroxine) thus should be given at least 2 hours apart.
•   Iron salts may reduce the bioavailability of Vitamin B12, zinc, methyldopa, the absorption of levodopa and penicillamine may also be reduced.
•   The absorption of iron salts is decreased in the presence of antacids and preparations containing calcium, phosphorus or when taken with tea, coffee, milk, eggs, wholegrain cereals and dietary fiber, alcohol. Therefore, oral iron preparations should not be taken within at least two hours after ingestion of these products.
•   Iron absorption may be increased by ascorbic or citric acid.
•   Serum levels of anticonvulsant drugs may be reduced by the co- administration of folate, the medicine may possibly reduce the plasma concentration of phenobarbital, phenytoin and primidone.
•   Absorption is possibly reduced also by sulfasalazine.
•   Anti cancer medication (aminopyrine, methotrexate)
•   Pyrimethamine for malaria
•   Triantine for Willson disease
•   Cholestyramine
•   Excessive alcohol consumption can influence vitamin absorption.