Monnax/Monnax Plus Drug Interactions

Monnax Plus chewable tablet: Antacids decrease the absorption of Tetracycline and Iron. Take Tetracycline 1 hour before or 2 hours after antacids and 2 hours before or 3 hours after iron-containing preparations.
Antacids may decrease the absorption of orally administered Digoxin, or Indomethacin, Isoniazid, Quinolones (e.g. Ciprofloxacin, Ofloxacin), Ketoconazole. Doses of these should be spaced as far as possible from doses of antacids.
Antacid-induced changes in urine pH increase urinary excretion and decrease blood concentration of salicylates such as Aspirin.
Antacid-induced increases in urine pH may decrease excretion of weakly basic drugs (e.g. Quinidine, Chlorpromazine, Propranolol, Diazepam) and increase excretion of weakly basic drugs (e.g. Phenytoin, Pentobarbital, Warfarin).
Aluminum-Magnesium antacid combination is reported to increase the absorption of Dicumarol, Diazepam and Pseudoephedrine.
Magnesium and Aluminum Hydroxide administration may decrease the rate of Chlordiazepoxide absorption.
Antacids reduce the bioavailability of bisphosphonates (e.g. Alendronate, Etidronate, Risedronate).
Monnax/Monnax Plus oral suspension: Aluminium hydroxide may form complexes with certain drugs eg, tetracyclines, digoxin and vitamins, resulting in decreased absorption. This should be borne in mind when concomitant administration is considered.
Concomitant use with quinidines may increase the serum levels of quinidine and lead to quinidine overdosage.
Aluminium-containing antacids may prevent the proper absorption of H2-antagonists, atenolol, chloroquine, cyclines, diflunisal, digoxin, diphosphonates, ethambutol, fluoroquinolones, sodium fluorine, glucocorticoids, indomethacin, isoniazid, kayexalate, ketoconazole, lincosamides, metoprolol, neuroleptics, phenothiazines, penicillamine, propranolol, iron salts.
Staggering the administration times of the interacting drug and the antacid by at least 2 hrs (4 hrs for the fluoroquinolones) will often help avoid undesirable drug interactions.