Interactions : אינטראקציות

4.5.   Interaction with other medicinal products and other forms of interaction
Inadvisable combinations
• Iron (salts) (by injection)
Lipothymia, or even shock, attributed to the rapid release of iron in its complex form and siderophilin saturation.

Combinations to be taken into account
• Acetohydroxamic acid
Reduced gastrointestinal absorption of both medicinal products by iron chelation.

Combinations requiring special precautions for use
• Bictegravir
Two-thirds decrease in gastrointestinal absorption of bictegravir if both products are administered simultaneously or on an empty stomach.
Bictegravir should be administered at least 2 hours before iron salts or taken together with food.
Bisphosphonates
Reduced gastrointestinal absorption of bisphosphonates due to formation of poorly absorbed complexes.
Do not take iron salts at the same time as bisphosphonates (leave an interval of at least 30 minutes to more than 2 hours, where possible, depending on the bisphosphonate).
• Cyclins (oral route)
Reduced gastrointestinal absorption of cyclins and iron.
Do not take iron salts at the same time as cyclins (leave an interval of more than 2 hours where possible).
• Fluoroquinolones
Reduced gastrointestinal absorption of fluoroquinolones.
Do not take iron salts at the same time as fluoroquinolones (leave an interval of more than 2 hours where possible).
• Penicillamine
Reduced gastrointestinal absorption of penicillamine.
Do not take iron salts at the same time as penicillamine (leave an interval of more than 2 hours where possible).
• Entacapone
Reduced gastrointestinal absorption of entacapone and iron caused by chelation of the iron by the entacapone.
Do not take iron salts at the same time as entacapone (leave an interval of more than 2 hours where possible).
• Thyroid hormones
Reduced gastrointestinal absorption of thyroid hormones.
Do not take thyroid hormones at the same time as iron (leave an interval of more than 2 hours where possible).
• Calcium
Reduced gastrointestinal absorption of iron salts.
Do not take iron salts at meal times or with calcium.
• Zinc, Strontium Reduced gastrointestinal absorption of zinc or strontium caused by iron.
Do not take iron salts at the same time as zinc or strontium (leave an interval of more than 2 hours where possible).
• Methyldopa, Levodopa
Reduced gastrointestinal absorption of methyldopa and levodopa.
Do not take iron salts at the same time as methyldopa and levodopa (leave an interval of more than 2 hours where possible).
• Topical gastrointestinal treatments, antacids, and adsorbents Reduced gastrointestinal absorption of iron salts.
As a precaution, do not take topical treatments or antacids at the same time as iron salts (leave an interval of more than 2 hours where possible).
• Integrase inhibitors Reduced gastrointestinal absorption of integrase inhibitors.
Do not take iron salts at the same time as antiretrovirals (leave an interval of more than 2 hours where possible).
• Trientine
Reduction in the concentrations of serum iron.
Do not take trientine at the same time as iron salts.

Other forms of interactions
Phytic acids (whole grains), polyphenols (tea, coffee, red wine), calcium (milk, dairy products), and some proteins (eggs) significantly inhibit iron absorption. An interval of at least 2 hours should be left between taking iron salts and these foods.