Medicine/Supplement interaction question - What do you think?

[Guest guest]

What do you all think?

Family member prescribed moxifloxacin antibiotic. 1 Tablet/ day.

The label reads: Take either 4 hours before or 8 hours after taking

antiacids or multivitamin.

So, out of curiosity, I check out _www.rxlist.com_ (http://www.rxlist.com)

.. It states the following in Prescribing info (like online PDR).

Oral doses of moxifloxacin should be administered at least 4 hours before

or 8 hours after antacids containing magnesium or aluminum, as well as

sucralfate, metal cations such as iron, and multivitamin preparations with zinc,

or VIDEX® (didanosine) chewable/buffered tablets or the _pediatric_

(http://www.rxlist.com/script/main/art.asp?articlekey=4812) powder for oral

solution

BUT THEN, HERE'S the science:

Antacids

When moxifloxacin (single 400 mg tablet dose) was administered two hours

before, concomitantly, or 4 hours after an aluminum/magnesium-containing

antacid (900 mg aluminum hydroxide and 600 mg magnesium hydroxide as a single

oral dose) to 12 healthy volunteers there was a 26%, 60% and 23% reduction

in the mean AUC of moxifloxacin, respectively. Moxifloxacin should be taken

at least 4 hours before or 8 hours after antacids containing magnesium or

aluminum, as well as sucralfate, metal cations such as iron, and

multivitamin preparations with zinc, or VIDEX® (didanosine) chewable/ buffered

tablets

or the pediatric powder for oral solution. (See PRECAUTIONS: _DRUG

INTERACTIONS_ (http://www.rxlist.com/avelox-drug.htm#) and _DOSAGE AND

ADMINISTRATION_ (http://www.rxlist.com/avelox-drug.htm#) .)

Iron

When moxifloxacin tablets were administered concomitantly with iron

(ferrous sulfate 100 mg once daily for two days), the mean AUC and Cmax of

moxifloxacin was reduced by 39% and 59%, respectively. Moxifloxacin should only

be

taken more than 4 hours before or 8 hours after iron products. (See

PRECAUTIONS: _DRUG INTERACTIONS_ (http://www.rxlist.com/avelox-drug.htm#) and

_DOSAGE AND ADMINISTRATION_ (http://www.rxlist.com/avelox-drug.htm#) .)

Now, the label does not mention anything about taking with MINERALS iron

or zinc.

NOR does it say to not take with laxitives - (Thinking Milk of Magnesia?

have no clue if people really use this, we never have.)

So, how many people think their calcium/magnesium/zinc supplement for bone

health is safe cuz it's not a vitamin.

Or their iron supplement?

Or is it just the RD in me that doesn't like the inaccuracy of the label,

since most " vitamins " are multivitamin/mineral preparations in the average

person's mind, and the average person would just stop all supplements,

vitamins AND minerals?

Jan Patenaude, RD, CLT

Consultant, Writer, Speaker

Director of Medical Nutrition

Signet Diagnostic Corporation

(Mountain Time)

Fax:

DineRight4@...