Kremil-S Cool Relief Drug Interactions

Sodium alginate may decrease the absorption of minerals such as calcium, zinc, manganese, chromium, and magnesium if used concomitantly.
Antacids may interfere with the absorption of other medicines. It is advised that patients have an interval of at least two hours between taking a dose of an antacid and any other medicine.
Antacids may decrease the absorption of tetracyclines as a result of chelation of the cation by the antibiotic. Doses of tetracyclines should be given 1 to 2 hours after taking antacids.
Antacid-induced increases in urine pH may decrease excretion of weakly basic drugs (e.g., quinidine, chlorpromazine, propranolol, diazepam) and increase excretion of weakly acidic drugs (e.g., phenytoin, pentobarbital, warfarin).
Absorption of buffered or enteric-coated aspirin is increased by simultaneous use of antacids.
Antacid-induced changes in urine pH increase urinary excretion and decrease blood concentration of salicylates such as aspirin.
Administration of sodium bicarbonate with naproxen increases the rate of naproxen absorption.
Antacids also interact with enteric-coated tablets, capsules and granules. These products are formulated to resist gastric acid and dissolve in the more alkaline medium of the duodenum, releasing the drugs there. Enteric coatings may be disrupted prematurely in the presence of antacids, causing unwanted release of the drug in the stomach.
Concomitant administration of antacids and orally administered digoxin, indomethacin, or iron salts may decrease the absorption of these drugs.
Antacids can interact with fluoroquinolone antibacterials (e.g., ciprofloxacin, norfloxacin and ofloxacin) and penicillamine (for rheumatoid arthritis) to form insoluble metal ion chelates.
The absorption of antifungals (e.g., ketoconazole, itraconazole) is reduced in the presence of antacids, as these drugs are less readily soluble in an alkaline than in an acid medium.
Other drugs whose absorption is likely to be reduced in the presence of antacids include azithromycin, nitrofurantoin, rifampicin, phenytoin, chloroquine (to prevent malaria), phenothiazine antipsychotics (e.g., chlorpromazine for mental problems), and bisphosphonates (e.g., alendronate, etidronate, risedronate).