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PL Detail-Document #300313

−This PL Detail-Document gives subscribers


additional insight related to the Recommendations published in−
PHARMACIST’S LETTER / PRESCRIBER’S LETTER
March 2014

Drugs with Different Salt Forms


Drug and Its Salt Forms What’s the Difference?a,b
Bupropion (oral) •Equivalent doses:10
•Bupropion hydrobromide-U.S. bupropion HBr 174 mg = bupropion HCl 150 mg;
(Aplenzin) bupropion HBr 348 mg = bupropion HCl 300 mg;
•Bupropion hydrochloride bupropion HBr 522 mg = bupropion HCl 450 mg.
(Wellbutrin XL, etc) •Go to our PL Chart, Comparison of Bupropion Products (U.S.
products), for information about individual products.

Calcium supplements (oral) •Calcium salts can differ with regard to elemental calcium
Calcium acetate, calcium carbonate, content, absorption, etc.
calcium citrate, etc. •Go to our PL Chart, Comparison of Oral Calcium Salts, for
information about individual products.

Desvenlafaxine (oral) •Equivalent doses:11,12


•Desvenlafaxine base (Khedezla-U.S.) desvenlafaxine fumarate 75.45 mg =
•Desvenlafaxine fumarate-U.S. desvenlafaxine base or succinate 50 mg;
•Desvenlafaxine succinate (Pristiq) desvenlafaxine fumarate 150.9 mg = desvenlafaxine base or
succinate 100 mg.

Diclofenac (oral) •The potassium salt may be absorbed faster than the sodium
•Diclofenac potassium salt and therefore have a quicker onset of action.1
(Cambia, Cataflam-U.S., Voltaren •Go to our PL Chart, Comparison of Diclofenac Products (U.S.
Rapide-Canada, etc) products), for information about individual products.
•Diclofenac sodium
(Voltaren, etc)

Doxycycline (oral) •Doxycycline hyclate is more acidic than doxycycline


•Doxycycline hyclate monohydrate and might cause more GI upset.2
(Vibra-Tabs, etc) •Go to our PL Chart, Comparison of Oral Doxycycline
•Doxycycline monohydrate Products (U.S. products), for information about individual
(Apprilon-Canada, Monodox-U.S., etc) products.
Erythromycin (oral) •There is no clinical reason to recommend one product over
•Erythromycin ethylsuccinate another.
(E.E.S., etc) •Go to our PL Chart, Comparison of Oral Erythromycins (U.S.
•Erythromycin stearate products), for information about individual products.
(Erythrocin-U.S., Erythro-S-Canada,
etc)
•Erythromycin base
(ERYC, etc)

More. . .
Copyright © 2014 by Therapeutic Research Center
3120 W. March Lane, Stockton, CA 95219 ~ Phone: 209-472-2240 ~ Fax: 209-472-2249
www.PharmacistsLetter.com ~ www.PrescribersLetter.com ~ www.PharmacyTechniciansLetter.com
(PL Detail-Document #300313: Page 2 of 4)

Drug and Its Salt Forms What’s the Difference?a,b


Esomeprazole (oral) •Esomeprazole strontium is not approved for use in children
•Esomeprazole magnesium (Nexium) and infants due to concern about adverse effects of strontium on
•Esomeprazole strontium-U.S. growing bones.3
•Equivalent doses:3
esomeprazole strontium 24.65 mg = esomeprazole 20 mg;
esomeprazole strontium 49.3 mg = esomeprazole 40 mg.

Fluticasone (nasal) •There is no clinical reason to recommend one product over


•Fluticasone furoate another.13,14
(Avamys-Canada, Veramyst-U.S.) •Go to our PL Chart, Nasal Sprays for Allergic Rhinitis (U.S.
•Fluticasone propionate products), for information about individual products.
(Flonase, etc)

Hydroxyzine (oral) •There is no clinical difference between hydroxyzine pamoate


•Hydroxyzine hydrochloride and hydroxyzine hydrochloride.4
(Atarax, etc)
•Hydroxyzine pamoate-U.S.
(Vistaril, etc)

Iron supplements (oral) •Iron salts can differ with regard to elemental iron content,
Ferric ammonium citrate, ferrous absorption, tolerability, etc.
gluconate, iron sulfate, etc. •Go to our PL Chart, Comparison of Oral Iron Supplements,
for information about individual products.

Magnesium supplements (oral) •Magnesium salts can differ with regard to elemental
Magnesium carbonate, magnesium magnesium content, absorption, tolerability, etc.
chloride, magnesium citrate, etc. •Go to our PL Chart, Comparison of Oral Magnesium Salts, for
information about individual products.

Metoprolol (oral) •Metoprolol tartrate is only available as an immediate-release


•Metoprolol succinate-U.S. dosage form in the U.S. Metoprolol succinate is an extended-
(Toprol-XL) release dosage form.5
•Metoprolol tartrate •Metoprolol succinate has been proven to reduce mortality in
(Lopressor, etc) heart failure and is preferred over immediate-release metoprolol
tartrate in these patients.5
•Go to our PL Chart, Comparison of Oral Beta-Blockers (U.S.
products), for information about individual products.

Nitrates (oral) •Dosing schedules differ for isosorbide dinitrate and isosorbide
•Isosorbide dinitrate mononitrate.6
•Isosorbide mononitrate •Isosorbide dinitrate immediate-release is the preferred nitrate
(Imdur, etc) for heart failure.6
•Go to our PL Chart, Comparison of Nitrate Preparations
(U.S. products), for information about individual products.

More. . .
Copyright © 2014 by Therapeutic Research Center
3120 W. March Lane, Stockton, CA 95219 ~ Phone: 209-472-2240 ~ Fax: 209-472-2249
www.PharmacistsLetter.com ~ www.PrescribersLetter.com ~
www.PharmacyTechniciansLetter.com
(PL Detail-Document #300313: Page 3 of 4)

Drug and Its Salt Forms What’s the Difference?a,b


Omeprazole (oral) •There is no clinical difference between Losec caps and tabs.8
•Omeprazole base •Equivalent doses:
(Losec capsules-Canada, Prilosec-U.S., omeprazole base 20 mg = omeprazole magnesium 20.6 mg.7
etc)
•Omeprazole magnesium
(Losec tablets-Canada, Prilosec OTC-
U.S., etc)

Pantoprazole (oral) •There does not appear to be a clinical difference between


•Pantoprazole sodium pantoprazole magnesium and pantoprazole sodium.9
(Pantoloc-Canada, Protonix-U.S., etc)
•Pantoprazole magnesium-Canada
(Tecta)

Potassium supplements (oral) •Potassium salts can differ with regard to elemental potassium
Potassium chloride, potassium content, absorption, etc.
phosphate, potassium bicarbonate, etc. •Go to our PL Chart, Comparison of Oral Potassium Salts, for
information about individual products.

a. Different salt forms of a drug may have different indications or uses.


b. Formulation, delivery device, etc. may also contribute to differences between products.

Users of this PL Detail-Document are cautioned to use their own professional judgment and consult any other
necessary or appropriate sources prior to making clinical judgments based on the content of this document. Our
editors have researched the information with input from experts, government agencies, and national organizations.
Information and internet links in this article were current as of the date of publication.

More. . .
Copyright © 2014 by Therapeutic Research Center
3120 W. March Lane, Stockton, CA 95219 ~ Phone: 209-472-2240 ~ Fax: 209-472-2249
www.PharmacistsLetter.com ~ www.PrescribersLetter.com ~
www.PharmacyTechniciansLetter.com
(PL Detail-Document #300313: Page 4 of 4)

Project Leader in preparation of this PL Detail- 7. Product monograph for Losec capsules.
Document: Stacy A. Hester, R.Ph., BCPS, AstraZeneca Canada. Mississauga, ON L4Y 1M4.
August 2013.
Assistant Editor 8. Product information for Prilosec OTC. Procter &
Gamble. Cincinnati, OH 45202. June 2011.
References 9. Hein J. Comparison of the efficacy and safety of
1. Chuasuwan B, Binjesoh V, Polli JE, et al. pantoprazole magnesium and pantoprazole sodium
Biowaiver monographs for immediate-release solid in the treatment of gastro-oesophageal reflux
oral dosage forms: diclofenac sodium and disease. Clin Drug Investig 2011;31:655-64.
diclofenac potassium. J Pharmaceut Sci 10. PL Detail-Document, New Dosage Form: Aplenzin
2009;98:1206-19. (Bupropion Hydrobromide Extended-Release).
2. Pages F, Boutin JP, Meynard JB, et al. Tolerability Pharmacist's Letter/Prescriber's Letter. May 2009.
of doxycycline monohydrate salt vs. chloroquine- 11. Product information for desvenlafaxine fumarate.
proguanil in malaria chemoprophylaxis. Trop Med Teva. Sellersville, PA 18960. October 2013.
Int Health 2002;7:919-24. 12. Product information for Khedezla. Par. Spring
3. PL Detail-Document, Esomeprazole Strontium. Valley, NY 10977. September 2013.
Pharmacist’s Letter/Prescriber’s Letter. February 13. PL Detail-Document, New Drug: Avamys
2014. (Fluticasone Furoate). Pharmacist's
4. Product information for hydroxyzine pamoate. Letter/Prescriber's Letter. December 2007.
Danbury. Danbury, CT 06810. January 2007. 14. PL Detail-Document, New Nasal Steroids:
5. PL Detail-Document, Comparison of Oral Beta- Veramyst and Omnaris. Pharmacist's
Blockers. Pharmacist’s Letter/Prescriber’s Letter. Letter/Prescriber's Letter. June 2007.
December 2012.
6. PL Detail-Document, Comparison of Nitrate
Preparations. Pharmacist's Letter/Prescriber's
Letter. March 2010.

Cite this document as follows: PL Detail-Document, Drugs with Different Salt Forms. Pharmacist’s
Letter/Prescriber’s Letter. March 2014.

Evidence and Recommendations You Can Trust…


3120 West March Lane, Stockton, CA 95219 ~ TEL (209) 472-2240 ~ FAX (209) 472-2249
Copyright  2014 by Therapeutic Research Center

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