Delayed-Release Cysteamine Bitartrate/Bicarbonate Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

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 1 hour before or 1 hour 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) US prescribing information. Horizon Therapeutics USA, Inc. February, 2022.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.