D'Arcy P F, McElnay J C
Drug Intell Clin Pharm. 1987 Jul-Aug;21(7-8):607-17. doi: 10.1177/1060028087021007-806.
Antacids and adsorbents are commonly used preparations that are generally considered to be pharmacologically inert and free from adverse effects. They may, however, interact with a diverse range of primary drugs and the sequelae can be disadvantageous to the efficacy of the primary medication. Many such reports in the literature are based on animal experiments, or on single-dose studies in healthy subjects. Some reports are anecdotal and are unconfirmed; others are based solely on in vitro evidence. Potentially important interactions have been suggested for a relatively small group of drugs: tetracyclines, phenytoin, digoxin, chloroquine, cimetidine, quinidine, nonsteroidal antiinflammatory drugs, and beta-blocking agents. The evidence for these has been critically evaluated, as well as for antacid-anticoagulant and antacid-nitrofurantoin interactions that have been wrongly emphasized in the literature. The majority of literature reports on interactions with antacids have been overemphasized; only ferrous sulfate-, isoniazid-, and tetracycline-antacid interactions fall into a category I importance (scale I-III of descending importance). This category is for those interactions with good evidence of actual or potential importance in patients or in relevant studies on normal subjects.
抗酸剂和吸附剂是常用制剂，通常被认为药理活性低且无不良反应。然而，它们可能与多种主要药物发生相互作用，其后果可能对主要药物的疗效不利。文献中的许多此类报告基于动物实验或健康受试者的单剂量研究。一些报告属于轶事性质且未经证实；其他报告仅基于体外证据。对于相对少数的一组药物，即四环素、苯妥英、地高辛、氯喹、西咪替丁、奎尼丁、非甾体抗炎药和β受体阻滞剂，已表明存在潜在的重要相互作用。已对这些相互作用的证据以及文献中被错误强调的抗酸剂 - 抗凝剂和抗酸剂 - 呋喃妥因相互作用的证据进行了严格评估。大多数关于与抗酸剂相互作用的文献报告都被过度强调了；只有硫酸亚铁、异烟肼和四环素与抗酸剂的相互作用属于I类重要性（重要性从高到低分为I - III级）。该类别适用于那些在患者或正常受试者的相关研究中有充分证据表明实际或潜在重要性的相互作用。
