CERTAVITE-ANTIOXIDANT

Multivitamin and Multimineral, Oral tablet

Food

· Severity: Mild

· Notes for Consumers: Biotin may not work as well if you consume raw egg whites while taking this medication. If you notice unusual thinning of your hair or brittle nails, or if you think Biotin is not working as well for you, contact your prescriber.

· Notes for Professionals: Dietary avidin, a glycoprotein in raw egg whites (food), binds tightly to dietary biotin and prevents its absorption in the gastrointestinal tract. Cooking denatures the avidin, disabling it from interfering with biotin absorption.

Multivitamin and Multimineral, Oral tablet

Enteral Feedings

· Severity: Mild

· Notes for Consumers: Most iron supplements do not significantly interact with Enteral Feedings. However, Ferrous Sulfate syrups and elixirs, when given at the same time as Enteral feedings (examples: Boost, Ensure, Jevity, Sustical and others) may cause a thickening of the feeding that may increase the likelyhood of a tube clog. Such interactions are not common. However, to avoid this interaction, ferrous sulfate elixirs at least an hour before taking any nutritional supplement beverages down a tube. Alternatively, your health care professional may be able to recommend an iron supplement that would be less likely to interact.

· Notes for Professionals: Ferrous sulfate elixir has an acidic pH and has been reported to form precipitates with enteral feedings and may clog feeding tubes.

Multivitamin and Multimineral, Oral tablet

Food

· Severity: Major

· Notes for Consumers: Specific food or beverages including dairy products (such as cheese, milk, yogurt, or cottage cheese), coffee, or tea can decrease the absorption of Iron from the stomach. To limit this interaction, take Iron Salts (examples: Femiron, Feratab, Nephro-Fer, Slow FE) at least 1 hour before or 2 hours after meals. If stomach upset occurs, Iron Salts may be given with meals. However, where possible, avoid coffee, tea, or dairy products within 1 hour before or 2 hours after taking any Iron product. Taking these food together while taking Iron Salts can decrease the effectiveness to increase the amount of Iron in the body. In addition, Enteral Feedings (liquid nutritional feedings such as Ensure, Isocal, Jevity and others) are not recommended to be given within the 1 hour before and 1 hour after giving Ferrous Sulfate Elixir (example: Feosol Elixir). There does not appear to be an interaction with other liquid Iron products.

· Notes for Professionals: For better iron absorption, administer iron salts 1 hour before or 2 hours after meals. If GI irritation occurs, the iron supplement may be administered with meals. However, where possible, avoid administering coffee, tea, or dairy products within 1 hour before or 2 hours after giving iron.

Multivitamin and Multimineral, Oral tablet

Alcohol

· Severity: Moderate

· Notes for Consumers: Do not drink alcohol while taking this medication. Drinking alcohol while taking this medication may cause facial flushing or redness.

· Notes for Professionals: Alcohol-containing beverages or hot beverages/foods can exacerbate cutaneous vasodilation caused by niacin and should be avoided around the time of niacin ingestion. In general, this interaction would not be harmful, but might decrease patient tolerance of niacin. Alcohol and niacin, particularly sustained-release niacin, are both potentially hepatotoxic. Although no data are available regarding enhanced hepatotoxicity, excessive alcohol use should be discouraged.

Multivitamin and Multimineral, Oral tablet

Food

· Severity: Moderate

· Notes for Consumers: Avoid taking Phosphorus Salts at the same time with foods which contain oxalates (rhubarb, spinach, tomatoes, celery, nuts, beans, berries, chocolate) or phytates (bran and whole-grain cereals). These foods can decrease the amount of Phosphorus absorbed from the stomach. To limit this interaction, avoid these foods within 2 hours of taking Phosphorus Salts.

· Notes for Professionals: Foods containing oxalates (found in vegetables like rhubarb, tomatoes, celery, and spinach; as well as berries, beans, nuts and chocolate) or phytates (found in bran and whole-grain cereals) may reduce the absorption of phosphorus by forming complexes with the phosphorus salt.

Multivitamin and Multimineral, Oral tablet

Food

· Severity: Mild

· Notes for Consumers: Food interactions with Cyanocobalamin are for the most part insignificant. However, if you use the intranasal Cyanocobalamin supplements (Nascobal), you should avoid drinking hot liquids or eating very hot foods within 1 hour before or after using the nasal spray or gel. Hot foods/liquids can make the nose runny, which can limit the amount of vitamin absorbed thru the nose.

· Notes for Professionals: The intranasal forms of cyanocobalamin, vitamin B12, should be administered at least one hour before or one hour after ingestion of hot foods or liquids. Hot foods may cause nasal secretions and a resulting loss of medication or medication efficacy. Interactions between foods and oral or injectable forms of cyanocobalamin are not expected.

Multivitamin and Multimineral, Oral tablet

Foods containing olestra

· Severity: Mild

· Notes for Consumers: If large amounts of foods containing olestra are eaten (such as WOW chips, fat-free Pringles, or Utz Yes potato chips), the absorbtion of certain vitamins, including Phytonadione, Vitamin K 1, may be decreased.

· Notes for Professionals: The food supplement olestra, if ingested in sufficient quantities, may decrease the oral absorption of vitamin K.

Multivitamin and Multimineral, Oral tablet

Enteral Feedings

· Severity: Mild

· Notes for Consumers: If you need to use Enteral feedings (examples: Ensure, Jevity and others) as your sole nutritional dietary intake for long periods of time, you may be at risk for Zinc deficiency, as the feeding may impair the absorption of zinc. This interaction is not a concern if you simply use these products as supplements to a normal diet; true zinc deficiency is relatively rare. If you take Enteral Feedings as your only diet for long periods of time, you may need to discuss the use of additional mineral supplements with your prescriber. If you do take a Zinc supplement, it is best to take it at least 1 hour before or 1 hour after you have taken any feeding, meal, or beverage.

· Notes for Professionals: Absorption of zinc from enteral feedings may be impaired, despite the presence of zinc as a component of the enteral feeding formula; patients on chronic enteral feeding therapy may require additional zinc supplementation to ensure adequate nutritional intake.

Multivitamin and Multimineral, Oral tablet

Food

· Severity: Moderate

· Notes for Consumers: Taking oral Zinc Salts (dietary supplements or medicines like Galzin, Zinc Sulfate, etc.) at the same time as food or beverages, other than water, can reduce the amount of zinc absorbed. Breads, vegetables, fruits, eggs, and beverages like milk or coffee are all known to decrease zinc supplement absorption. If you do take a Zinc supplement, it is best to take it at least 1 hour before or 1 hour after you have taken any feeding, meal, or beverage.

· Notes for Professionals: Breads, vegetables, fruits, eggs, and beverages appear to interfere with the oral absorption of Zinc. For optimal absorption, oral zinc salts should be separated from food and beverages, other than water, by at least 1 hour.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>