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Interactions between your drugs

Moderate
sucralfate vs aluminum hydroxide
Applies to: sucralfate, aluminum hydroxide / magnesium hydroxide / simethicone

Using sucralfate together with aluminum hydroxide can decrease the effects of
sucralfate. Sucralfate and aluminum hydroxide doses should be separated by at
least half an hour. You may need a dose adjustment or special test to safely use
both medications. 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.

ADJUST DOSING INTERVAL: Antacid-induced gastric pH changes may reduce


binding of sucralfate with the gastrointestinal mucosa resulting in reduced
therapeutic efficacy. In addition, aluminum may accumulate in patients with renal
failure who are concomitantly taking sucralfate with aluminum-containing
antacids.

MANAGEMENT: Sucralfate and antacid doses should be separated by at least half


an hour.

Moderate
sucralfate vs magnesium hydroxide
Applies to: sucralfate, magnesium hydroxide, aluminum hydroxide / magnesium
hydroxide / simethicone

Using sucralfate together with magnesium hydroxide can decrease the effects
of sucralfate. Sucralfate and magnesium hydroxide doses should be separated by
at least half an hour. You may need a dose adjustment or special test to safely
use both medications. 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.
ADJUST DOSING INTERVAL: Antacid-induced gastric pH changes may reduce
binding of sucralfate with the gastrointestinal mucosa resulting in reduced
therapeutic efficacy. In addition, aluminum may accumulate in patients with renal
failure who are concomitantly taking sucralfate with aluminum-containing
antacids.

MANAGEMENT: Sucralfate and antacid doses should be separated by at least half


an hour.

Moderate
magnesium hydroxide vs granisetron
Applies to: magnesium hydroxide, aluminum hydroxide / magnesium hydroxide /
simethicone, granisetron

Granisetron can cause an irregular heart rhythm that may be serious and
potentially life-threatening, although it is a relatively rare side effect. The risk is
increased if you have low blood levels of magnesium or potassium, which can
occur with bowel cleansing preparations or excessive use of medications that
have a laxative effect. Do not exceed the dose and duration of use
of magnesium hydroxiderecommended on the product label or prescribed by
your doctor. You should seek immediate medical attention if you develop
sudden dizziness, lightheadedness, fainting, shortness of breath, or heart
palpitations during treatment with these medications. In addition, you should let
your doctor know if you experience signs and symptoms of low magnesium or
potassium blood level such as weakness, tiredness, drowsiness, dizziness,
confusion, tingling, numbness, muscle pain, cramps, nausea, or vomiting. 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.

MONITOR: Bowel cleansing as well as overuse of certain laxatives may cause


electrolyte loss and increase the risk of torsade de pointes ventricular arrhythmia
in patients treated with drugs that prolong the QT interval. Electrolyte
disturbances including hypokalemia and hypomagnesemia have been reported
with laxative abuse and are known risk factors for torsade de pointes associated
with QT interval prolongation.

MANAGEMENT: Patients treated with drugs that prolong the QT interval should
exercise caution when self-medicating with laxatives. The recommended dosage
and duration of use should not be exceeded. Patients treated with lactulose for
more than six months should be monitored periodically for electrolyte imbalance.
Patients should be advised to seek prompt medical attention if they experience
symptoms that could indicate the occurrence of torsade de pointes such as
dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness
of breath, or syncope.