Prenatal Multivitamin and Multimineral with Iron, Oral tablet
Tobacco
· Severity: Mild
· Notes for Consumers: Although an interaction is possible, people who smoke may take Levomefolate. Smoking may decrease Levomefolate levels in the body. Additional Levomefolate may be recommended if you smoke. Ask your prescriber if you have questions regarding your Levomefolate intake.
· Notes for Professionals: Levomefolate plasma concentrations may be decreased in patients who use tobacco. Monitor patients who use tobacco products for decreased efficacy of levomefolate.
Prenatal Multivitamin and Multimineral with Iron, Oral tablet
Food
· Severity: Major
· Notes for Consumers: Specific food or beverages including dairy products (such as cheese, milk, yogurt, or cottage cheese), coffee, or tea can decrease the absorption of Iron from the stomach. To limit this interaction, take Iron Salts (examples: Femiron, Feratab, Nephro-Fer, Slow FE) at least 1 hour before or 2 hours after meals. If stomach upset occurs, Iron Salts may be given with meals. However, where possible, avoid coffee, tea, or dairy products within 1 hour before or 2 hours after taking any Iron product. Taking these food together while taking Iron Salts can decrease the effectiveness to increase the amount of Iron in the body. In addition, Enteral Feedings (liquid nutritional feedings such as Ensure, Isocal, Jevity and others) are not recommended to be given within the 1 hour before and 1 hour after giving Ferrous Sulfate Elixir (example: Feosol Elixir). There does not appear to be an interaction with other liquid Iron products.
· Notes for Professionals: For better iron absorption, administer iron salts 1 hour before or 2 hours after meals. If GI irritation occurs, the iron supplement may be administered with meals. However, where possible, avoid administering coffee, tea, or dairy products within 1 hour before or 2 hours after giving iron.
Prenatal Multivitamin and Multimineral with Iron, Oral tablet
Alcohol
· Severity: Moderate
· Notes for Consumers: Ethanol can decrease the actions of Magnesium Salts, by increasing its elimination from the body. To get the best results, limit your intake of alcoholic beverages while taking Magnesium Salts or supplements.
· Notes for Professionals: Excessive ethanol (e.g., alcoholism) may result in increased urinary excretion of magnesium. Avoid high intakes of ethanol while taking magnesium salts.
Prenatal Multivitamin and Multimineral with Iron, Oral tablet
Enteral Feedings
· Severity: Mild
· Notes for Consumers: Most iron supplements do not significantly interact with Enteral Feedings. However, Ferrous Sulfate syrups and elixirs, when given at the same time as Enteral feedings (examples: Boost, Ensure, Jevity, Sustical and others) may cause a thickening of the feeding that may increase the likelyhood of a tube clog. Such interactions are not common. However, to avoid this interaction, ferrous sulfate elixirs at least an hour before taking any nutritional supplement beverages down a tube. Alternatively, your health care professional may be able to recommend an iron supplement that would be less likely to interact.
· Notes for Professionals: Ferrous sulfate elixir has an acidic pH and has been reported to form precipitates with enteral feedings and may clog feeding tubes.