Drug Interaction Report

Magnesium Trisilicate and Omadacycline: Interaction Details

A pharmacist-reviewed analysis of the Magnesium Trisilicate and Omadacycline interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Omadacycline

Nuzyra Nuzyra®
+

Magnesium Trisilicate

No brand names on record
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Moderate
Can be significant — usually manageable with monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 52 documented Magnesium Trisilicate interactions, 30 are rated moderate — including this one.
Onset
rapid
Evidence
probable
Severity
Moderate

What happens

Decreased effectiveness of omadacycline

Interaction Deep Dive

Cation-containing products (eg, those with aluminum, calcium, magnesium, bismuth subsalicylate, iron) may impair omadacycline absorption. Wait at least 4 hours after oral omadacycline administration to take antacids or multivitamins1.

Why it happens (mechanism)

Decreased absorption of omadacycline

Literature reports

2 reports — tap to read

a) Antacids containing divalent or trivalent cations (calcium, magnesium, aluminum) impair the absorption of oral tetracyclines and result in decreased serum levels 23.

b) Combined therapy with oral antacids (aluminum hydroxide gel) and intravenous doxycycline resulted in a significant increase in the total clearance and renal clearance of doxycycline for six healthy volunteers. The subjects were given intravenous doxycycline 200 mg on two occasions, separated by a 7-day washout period; on one occasion, oral aluminum hydroxide gel was given concomitantly beginning 48 hours prior to the doxycycline and continuing for a total of 16 doses as 30 mL four times daily. When given concomitantly with antacids, the half-life of doxycycline decreased from 16.2 to 11.2 hours and the total body clearance increased from 37.4 to 54.1 mL/min. In addition, the area under the plasma concentration-time curve (AUC) decreased significantly with an increase in renal clearance 4.

Common questions

Can I take Magnesium Trisilicate and Omadacycline together?

Decreased effectiveness of omadacycline Always confirm with your pharmacist or prescriber before making any change.

How serious is the Magnesium Trisilicate and Omadacycline interaction?

It is rated moderate. Can be significant — usually manageable with monitoring.

How quickly could this interaction happen?

The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

  • Does my dose of Magnesium Trisilicate or Omadacycline need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there anything you'd monitor while I'm on both?

References (4)

  1. Product Information: NUZYRA(TM) intravenous injection, oral tablets, omadacycline intravenous injection, oral tablets. Paratek Pharmaceuticals Inc (per manufacturer), Boston, MA, 2018. DailyMed
  2. Neuvonen PJ: Interactions with the absorption of tetracyclines. Drugs 1976b; 11:45-54. PubMed
  3. Chin TF & Lach JL: Drug diffusion and bioavailability: tetracycline metallic chelation. Am J Hosp Pharm 1975; 32:625-629. DOI
  4. Nguyen VX, Nix DE, Gillikin S, et al: Effect of oral antacid administration on the pharmacokinetics of intravenous doxycycline. Antimicrob Agents Chemother 1989; 33:434-436. DOI
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Omadacycline

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Magnesium Trisilicate

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