How the interaction occurs:
Bicarbonate increases the pH (decreases the acidity) of your stomach. Delayed-release cysteamine bitartrate needs an acidic environment in order to be dissolved slowly to provide a consistent level of cysteamine bitartrate throughout the day.
What might happen:
Delayed-release cysteamine bitartrate may dissolve too quickly and its effects may not last throughout the day. If there is not enough cysteamine bitartrate in your body throughout the day, it may not work as well against the build up of cystine in your body.
What you should do about this interaction:
Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together.Take your cysteamine bitartrate either 30 minutes prior to or 30 minutes after taking your bicarbonate. If you have any questions about how to take your medication, ask your pharmacist.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Navarrete T. Personal Communication - Procysbi and bicarbonate. Raptor Pharmaceuticals Inc. May 9, 2013.
2.Langman CB, Greenbaum LA, Sarwal M, Grimm P, Niaudet P, Deschenes G, Cornelissen E, Morin D, Cochat P, Matossian D, Gaillard S, Bagger MJ, Rioux P. A randomized controlled crossover trial with delayed-release cysteamine bitartrate in nephropathic cystinosis: effectiveness on white blood cell cystine levels and comparison of safety. Clin J Am Soc Nephrol 2012 Jul;7(7):1112-20.
3.Procsybi (cysteamine bitratrate) Delayed-Release Capsules. Raptor Pharmaceuticals Inc. April, 2013.