[net.med] Tetracycline and Antacids

dave@cylixd.UUCP (Dave Kirby) (02/19/86)

On many antacids I see the warning "Do not take if you are currently
taking any prescription medication containing any form of tetracycline."

What are the side effects from disregarding this warning and taking
the two together?

-----------------------------------------------------------------
Dave Kirby    ( ...!ihnp4!akgub!cylixd!dave)

stu16@whuxl.UUCP (Pippin) (02/19/86)

> 
> On many antacids I see the warning "Do not take if you are currently
> taking any prescription medication containing any form of tetracycline."
> 
> What are the side effects from disregarding this warning and taking
> the two together?


     I was told by my MD that the reason for this warning is
because the antacids inhibits the action of tetracyline. As
far as he knew, there were no side effects, per se. Just
that the antibiotic would not have much effect on whatever
it was precribed for. I think it's much the same for some
other antibiotics as well. But it's ok to take the antacid
2 hrs before or after the antibiotic. 
-- 
                      Pippin Stuart
                      whuxl!stu16

dyer@harvard.UUCP (Steve Dyer) (02/21/86)

Tetracyclines chelate calcium and other metal ions like magnesium and
aluminum forming an insoluble complex which is not absorbed by the gut.
By drinking milk or other calcium-containing dairy products or
by taking antacids such as Maalox, you effectively lower the dosage
of antibiotic (if not remove it entirely.)  Thus, the combination
isn't toxic, but it may be dangerous, since, presumably you're taking
the antibiotic for a reason.

-- 
/Steve Dyer
dyer@harvard.harvard.edu
harvard!dyer

kasey@trsvax (02/26/86)

>On many antacids I see the warning "Do not take if you are currently
>taking any prescription medication containing any form of tetracycline."

>What are the side effects from disregarding this warning and taking
>the two together?

Antacids contain a high concentration of calcium.  So much so, in fact that
many woman take antacids to prevent osteoporosis (sp?).  Calcium prevents
tetracycline from performing its antibiotic duties.  So you are wasting your
money on the antibiotic if you take antacids with them.  Not to metion the
fact that you aren't curing whatever it is you need the antibiotic for.
There are no other side effects.

There should be a warning label on the side of the tetracycline bottle
warning you not to take it with milk products or iron.  My father takes
tetracycline for emphysema.  He also needs a daily calcium supplement.  I 
give him his antibiotic in the moring and his calcium at night.  I
understand that it is best to take calcium supplements just before retiring
for the evening anyway.  It helps you sleep better because of its relaxing
effects and it is absorbed better. 

I'm not a doctor.  And this should not be construed as medical advice.  I just
subscribe to Prevention!

werner@aecom.UUCP (Craig Werner) (02/26/86)

>> 
>> On many antacids I see the warning "Do not take if you are currently
>> taking any prescription medication containing any form of tetracycline."
>> 
>> What are the side effects from disregarding this warning and taking
>> the two together?
> 
	Also the warning on Tetraycline: Do not take with anything containing
Calcium.   It's very simple. Tetracycline chelates Calcium, the chelate is
not absorbed. The tetracycline is excreted in the feces.  Result: no
antibiotic in the body. Presumably, one is taking Tetracycline for its
antibacterial effect, an effect that requires it to get into the body in
the first place.
	NB: This is not considered a 'Side Effect'. This is a 'Drug
Interaction'.

	Further note: it was recently shown that Antacids(and for that
matter Cimetidine) do no better than a Sugar pill placebo to releive
chronic ingestion.  Of course, it could be argued (and was duly noted) that
those people enrolled in the study probably went to the doctor in the
first place becausetheir home remedies didn't work.

	Second Note: If you are taking the antacid as a Calcium supplement,
there is to date no evidence that calcium supplements actually delay the
development of Osteoporosis -- just very good reasoning to think that it
should.  Hence, for the duration of the Tetracycline, give up the Antacid -
it's not worth it.
-- 

				Craig Werner
				!philabs!aecom!werner
                        "It doesn't even have to be a Pelvis."

dyer@spdcc.UUCP (Steve Dyer) (02/27/86)

>	Further note: it was recently shown that Antacids (and for that
>matter Cimetidine) do no better than a Sugar pill placebo to releive
>chronic ingestion.  Of course, it could be argued (and was duly noted) that
>those people enrolled in the study probably went to the doctor in the
>first place because their home remedies didn't work.

This was reported recently in the NEJM.  Chronic indigestion (a rather
diffuse and non-specific condition) should be differentiated from
ulcers of the stomach and duodenum, and other situations associated with
excessive acid secretion, for which cimetidine and antacids are generally
helpful.  It just happens that "indigestion" isn't always due to stomach
acid.
-- 
Steve Dyer
dyer@harvard.HARVARD.EDU
{bbncca,bbnccv,harvard}!spdcc!dyer