Drug General Information (ID: DDIVNT85EZ)
Drug Name			Tetracycline		Drug Info		Ferrous sulfate anhydrous		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antibiotics				Iron Supplement
Structure

Mechanism of Tetracycline-Ferrous sulfate anhydrous Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Tetracycline				Ferrous sulfate anhydrous
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 sulfate anhydrous due to formation of complexes caused by Tetracycline

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	Campbell NR, Hasinoff BB "Iron supplements: a common cause of drug interactions." Br J Clin Pharmacol 31 (1991): 251-5. [PMID: 2054263]
2	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]
3	Product Information. Nuzyra (omadacycline). Paratek Pharmaceuticals, Inc., Boston, MA.