Drug General Information (ID: DDI52WY6B7)
Drug Name			Oxytetracycline		Drug Info		Ferrous fumarate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antibiotics				Iron Supplement
Structure

Mechanism of Oxytetracycline-Ferrous fumarate Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Oxytetracycline				Ferrous fumarate
Mechanism		Binds to polyvalent cations				Polyvalent cations
Key Mechanism Factor 1
		Factor Name		Chelation
		Factor Description		Chelation is a direct drug interaction that usually involves the formation of dimers or trimers, resulting in larger complexes and poorer absorption.
Mechanism Description		Decreased absorption of Ferrous fumarate due to formation of complexes caused by Oxytetracycline

Recommended Action
Management		Coadministration of a tetracycline with any iron-containing product should be avoided if possible. Otherwise, patients should be advised to stagger the times of administration by at least three to four hours, although separating the doses may not prevent the interaction with doxycycline.

References
1	Xu D, Xiao Y, Pan H, Mei Y. Toxic effects of tetracycline and its degradation products on freshwater green algae.?Ecotoxicol Environ Saf. 2019;174:43-47. [PMID: 30818259]
2	Campbell NR, Hasinoff BB "Iron supplements: a common cause of drug interactions." Br J Clin Pharmacol 31 (1991): 251-5. [PMID: 2054263]
3	Gothoni G, Neuvonen PJ, Mattila M, Hackman R "Iron-tetracycline interaction: effect of time interval between the drugs." Acta Med Scand 191 (1972): 409-11. [PMID: 5031537]
4	Greenberger NJ "Absorption of tetracyclines: interference by iron." Ann Intern Med 74 (1971): 792-3. [PMID: 5559446]
5	Neuvonen PJ "Interactions with the absorption of tetracyclines." Drugs 11 (1976): 45-54. [PMID: 946598]
6	Neuvonen PJ, Gothoni G, Hackman R, Bjorksten K "Interference of iron with the absorption of tetracyclines in man." Br Med J 4 (1970): 532-4. [PMID: 5483323]
7	Neuvonen PJ, Penttila O "Effect of oral ferrous sulphate on the half-life of doxycycline in man." Eur J Clin Pharmacol 7 (1974): 361-3. [PMID: 4607747]
8	Product Information. Minocin (minocycline). Lederle Laboratories, Wayne, NJ.
9	Product Information. Nuzyra (omadacycline). Paratek Pharmaceuticals, Inc., Boston, MA.
10	Product Information. Seysara (sarecycline). Allergan Inc, Irvine, CA.
11	Venho VM, Salonen RO, Mattila MJ "Modification of the pharmacokinetics of doxycycline in man by ferrous sulphate or charcoal." Eur J Clin Pharmacol 14 (1978): 277-80. [PMID: 729621]