Iberet Active Drug Interactions

Alcohol: Niacin with concomitant use of alcohol, toxic delirium and lactic acidosis has been noted.
Nicotine: Niacin with concomitant use of nicotine; increased flushing and dizziness have been reported.
Tetracyclines: Iron inhibits absorption of tetracyclines from the GI tract and vice versa. If both drugs must be given, administer tetracycline three hours after or two hours before oral iron supplements.
Chloramphenicol: Chloramphenicol may delay response to iron therapy, and may diminish response to B₁₂-deficient patients; alternate anti-infective therapy should be considered.
Antacids: Antacids may decrease iron absorption.
Cholestyramine: Cholestyramine may decrease iron absorption.
Quinolone Anti-infective Agents: Concurrent administration of oral iron preparations may interfere with the oral absorption of some quinolone anti-infective agents (e.g. ciprofloxacin, norftoxacin, ofloxacin) resulting in decreased serum and urine concentrations of the quinolones. Therefore, oral iron preparations should not be ingested with or within two hours of a dose of an oral quinolone.
Penicillamine: Iron decreases the cupruretic effect of penicillamines. If both drugs must be administered, then administration should be at least two hours apart.
Anti-diabetic agents: Dosage requirements for these agents may change while taking niacinamide.
Ganglionic Blocking Drugs: Niacin may potentiate the hypotensive effect of these agents.
Neuromuscular Blocking Agents: Thiamine may enhance the effect of these agents.
Propantheline Bromide: Prior administration of propantheline bromide may delay the absorption time but increase the absorption concentration of riboflavin.
Levodopa: Since pyridoxine is noted to have effects on dopamine, drug interactions are possible. A drug interaction with levodopa is noted, but can be avoided if levodopa is given in combination with a decarboxylase inhibitor.
Phenobarbital and Phenytoin: High doses of pyridoxine hydrochloride (greater than the 5 mg/day from lberet Active) have been reported to decrease serum concentrations of phenobarbital or phenytoin.
Vitamin B₁₂ Absorption From the GI Tract Can Be Diminished By Various Agents: Aminoglycoside antibiotics, colchicine, extended-release potassium preparations, aminosalicylic acid and its salts, anticonvulsants, cobalt irradiation of the small bowel, or chronic excessive alcohol intake. In older patients, serum B₁₂ levels should be regularly assessed during treatment with lberet Active.
Anticoagulants: Prothrombin times are decreased when ascorbic acid is used concomitantly with anticoagulants.
Drug Food Interactions: Absorption of iron is inhibited by ingestion of eggs, milk, phytate-containing substances such as bran, or tannins in tea.
Oral iron preparations should not be taken within one hour or two hours after ingestion of the above mentioned products.
Laboratory Tests: Iron: Iron preparations may turn stools black, which could hinder detection of occult blood in feces. The guaiac test also occasionally yields false-positive tests.
Ascorbic acid: As a strong reducing agent, ascorbic acid may interfere with tests based on oxidation- reduction reactions. Ascorbic acid In the urine may produce false results in glucosuria determinations. Prothrombin times are decreased when ascorbic acid Is used concomitantly with anticoagulants.
Niacin: Niacin may cause false elevations in fluorometric tests of urinary catecholamines. It may also give false positive results when a cupric sulfate solution (such as Benedict's reagent) is used for urinary glucose determination.
Thiamine and Pyridoxine Hydrochloride: Thiamine may cause false positive results in the phosphotungstate method for determination of uric acid. Thiamine or pyridoxine hydrochloride may cause false positive results for urobilinogen in the spot test using Ehrlich's reagent.
Riboflavin: Large doses of riboflavin may result in bright yellow urine, which may interfere with urinalysis based on spectrometry or color reactions. Riboflavin may also cause false elevations in fluorometric determinations of catecholamines or urobilinogen.
Vitamin B₁₂: Methotrexate, pyrimethamine, and most anti-infectives invalidate diagnostic microbiologic blood assays for vitamin B₁₂. Prior administration of this vitamin may result in false-positive test results for IF antibodies, which are present in approximately 50% of patients with pernicious anemia.