FERIVA Lifestyle Interactions

Multivitamin with Iron, Oral capsule, biphasic release

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 with Iron, Oral capsule, biphasic release

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 with Iron, Oral capsule, biphasic release

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 with Iron, Oral capsule, biphasic release

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 with Iron, Oral capsule, biphasic release

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 with Iron, Oral capsule, biphasic release

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 with Iron, Oral capsule, biphasic release

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 with Iron, Oral capsule, biphasic release

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 with Iron, Oral capsule, biphasic release

Alcohol

· Severity: Mild

· Notes for Consumers: If you regularly drink alcohol-containing drinks, you may have a lack of certain B-vitamins including Folic Acid, Vitamin B9. Discuss which supplements would be most appropriate for you with your health care provider. If you experience weakness, fatigue, numbness, tingling in fingers and toes, decreased appetite, diarrhea, hair loss, or depression, contact your health care prescriber.

· Notes for Professionals: Folate deficiency may result in patients with chronic alcohol or ethanol consumption, and especially in alcoholic cirrhosis. Such patients may derive most of their caloric intake from alcoholic beverages which do not contain adequate amounts of folic acid; in addition ethanol may affect folate metabolism increasing folate loss. Supplementation in patients known to have excessive alcohol intake is prudent. Avoidance of excessive intake of alcohol would be recommended to help treat the deficiency.

Multivitamin with Iron, Oral capsule, biphasic release

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 with Iron, Oral capsule, biphasic release

Alcohol

· Severity: Mild

· Notes for Consumers: If you regularly drink alcohol-containing drinks, you may have a lack of certain B-vitamins including Folic Acid, Vitamin B9. Discuss which supplements would be most appropriate for you with your health care provider. If you experience weakness, fatigue, numbness, tingling in fingers and toes, decreased appetite, diarrhea, hair loss, or depression, contact your health care prescriber.

· Notes for Professionals: Folate deficiency may result in patients with chronic alcohol or ethanol consumption, and especially in alcoholic cirrhosis. Such patients may derive most of their caloric intake from alcoholic beverages which do not contain adequate amounts of folic acid; in addition ethanol may affect folate metabolism increasing folate loss. Supplementation in patients known to have excessive alcohol intake is prudent. Avoidance of excessive intake of alcohol would be recommended to help treat the deficiency.

Multivitamin with Iron, Oral capsule, biphasic release

Alcohol

· Severity: Moderate

· Notes for Consumers: If you regularly drink alcohol-containing drinks, you may have a lack of certain B-vitamins including Cyanocobalamin, Vitamin B12. Discuss which supplements would be most appropriate for you with your health care provider. If you experience weakness, fatigue, numbness, tingling in fingers and toes, decreased appetite, diarrhea, hair loss, or depression, contact your health care prescriber.

· Notes for Professionals: The heavy consumption of ethanol for greater than 2 weeks has been reported to reduce the absorption of cyanocobalamin, vitamin B12. Patients should be aware that heavy, chronic ethanol use may counteract the therapeutic effects of vitamin B12; such patients with regular and chronic ethanol consumption be monitored for the desired therapeutic response to vitamin B12.

Multivitamin with Iron, Oral capsule, biphasic release

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 with Iron, Oral capsule, biphasic release

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 with Iron, Oral capsule, biphasic release

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 with Iron, Oral capsule, biphasic release

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 with Iron, Oral capsule, biphasic release

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 with Iron, Oral capsule, biphasic release

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 with Iron, Oral capsule, biphasic release

Alcohol

· Severity: Moderate

· Notes for Consumers: If you regularly drink alcohol-containing drinks, you may have a lack of certain B-vitamins including Cyanocobalamin, Vitamin B12. Discuss which supplements would be most appropriate for you with your health care provider. If you experience weakness, fatigue, numbness, tingling in fingers and toes, decreased appetite, diarrhea, hair loss, or depression, contact your health care prescriber.

· Notes for Professionals: The heavy consumption of ethanol for greater than 2 weeks has been reported to reduce the absorption of cyanocobalamin, vitamin B12. Patients should be aware that heavy, chronic ethanol use may counteract the therapeutic effects of vitamin B12; such patients with regular and chronic ethanol consumption be monitored for the desired therapeutic response to vitamin B12.

Multivitamin with Iron, Oral capsule, biphasic release

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.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

DISCLAIMER: This content is provided for informational purposes only. The content 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.

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