Abstract
A close scrutiny of deployment of the present day home medicines has shown increased
indulgence of antacids as a household remedy. While such household interventions are
considered innocuous, it could trigger potential drug-drug inter-action(s), if the
subject is taking other prescription medicine(s). Examination of the literature indicated
that co-administration of antacids may have the potential to cause therapy failures
due to reduced oral bioavailability of several drugs. Additionally, fortified foods
and beverages with mineral supplement may also have the potential to reduce the bioavailability
of oral drugs.
On the basis of this review a number of drugs displayed reduced oral bioavailability
in the presence of antacids. However, almost one third of the reviewed drugs showed
a drastic bioavailability reduction (< 50%) warranting total avoidance of antacid
ingestion in such drug uses. If antacid use is warranted, it needs to be carefully
monitored in relation to the administration of the drug (either pre or post drug administration).
It appeared that a safe window for antacid administration could be established especially
for drugs that display moderate reduction of oral bioavailability. While possible
mechanisms explaining the purported antacid-drug interaction are covered, additional
perspectives with regard to assessment protocols for antacid-drug interaction are
discussed.
Key words
Antacids - Drug-drug interaction, oral bioavailability, pharmacokinetics
