Wirkstoffe & Arzneimittelsicherheit

Wechselwirkungen · Modigraf

Modigraf 0.2 mg granules for oral suspension Modigraf 1 mg granules for oral suspension · Abschnitt 4.5 · PDF-Seite 10–11

HOS-209742 · Präparat HOS-154375

10 Medicinal products which have effects on tacrolimus Drug/Substance Class or Drug interaction effect Recommendations concerning co- Name administration Grapefruit or grapefruit juice May increase tacrolimus Avoid grapefruit or grapefruit whole blood trough juice. concentrations and increase the risk of serious adverse reactions (e.g., neurotoxicity, QT prolongation) [see section 4.4]. Ciclosporin May increase tacrolimus The simultaneous use of whole blood trough ciclosporin and tacrolimus should concentrations. In addition, be avoided [see section 4.4]. synergistic/additive nephrotoxic effects can occur. Products known to have May enhance nephrotoxic or Concurrent use of tacrolimus with nephrotoxic or neurotoxic neurotoxic effects of drugs known to have nephrotoxic effects: tacrolimus. effects should be avoided. When aminoglycosides, gyrase co-administration cannot be inhibitors, vancomycin, avoided, monitor renal function sulfamethoxazole + and other side effects and adjust trimethoprim, NSAIDs, tacrolimus dose if needed. ganciclovir, acyclovir, amphotericin B, ibuprofen cidofovir, foscarnet Strong CYP3A4 inhibitors: May increase tacrolimus It is recommended that antifungal agents (e.g., whole blood trough concomitant use should be ketoconazole, itraconazole, concentrations and increase avoided. If co-administration of a posaconazole, voriconazole), the risk of serious adverse strong CYP3A4 inhibitor is the macrolide antibiotics reactions (e.g., unavoidable, consider omitting (e.g., telithromycin, nephrotoxicity, the dose of tacrolimus the day the troleandomycin, neurotoxicity, QT strong CYP3A4 inhibitor is clarithromycin, josamycin), prolongation) which requires initiated. Reinitiate tacrolimus the HIV protease inhibitors (e.g., close monitoring [see next day at a reduced dose based ritonavir, nelfinavir, section 4.4]. on tacrolimus blood saquinavir), HCV protease Rapid and sharp increases in concentrations. Changes in both inhibitors (e.g., telaprevir, tacrolimus levels may occur, tacrolimus dose and/or dosing boceprevir, and the as early as within 1-3 days frequency should be combination of ombitasvir after co-administration, individualized and adjusted as and paritaprevir with despite immediate reduction needed based on tacrolimus ritonavir, when used with and of tacrolimus dose. Overall trough concentrations, which without dasabuvir), tacrolimus exposure may should be assessed at initiation, nefazodone, the increase > 5 fold. When monitored frequently throughout pharmacokinetic enhancer ritonavir combinations are (starting within the first few days) cobicistat and the kinase co-administered, tacrolimus and re-evaluated on and after inhibitors idelalisib, ceritinib. exposure may increase > 50 completion of the CYP3A4 Strong interactions have also fold. inhibitor. Upon completion, been observed with the Nearly all patients may appropriate dose and dosing macrolide antibiotic require a reduction in frequency of tacrolimus should be erythromycin tacrolimus dose and guided by tacrolimus blood temporary interruption of concentrations. Monitor renal tacrolimus may also be function, ECG for QT necessary. prolongation, and other side effects closely.

Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.

RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): foscarnet (HOS-110484) sulfamethoxazole (HOS-084533) ceritinib (HOS-086215) josamycin (HOS-113844) nefazodone (HOS-084519) nelfinavir (HOS-084520) ibuprofen (HOS-087884) protease (HOS-085623) amphotericin B (HOS-109312) trimethoprim (HOS-085184) ketoconazole (HOS-084513) cobicistat (HOS-088111) cidofovir (HOS-110482) grapefruit juice (HOS-088787) dasabuvir (HOS-110302) voriconazole (HOS-084524) telaprevir (HOS-090618) telithromycin (HOS-084523) itraconazole (HOS-084516) saquinavir (HOS-084522) ombitasvir (HOS-110300) boceprevir (HOS-090617) clarithromycin (HOS-084517) vancomycin (HOS-110486) erythromycin (HOS-084514) troleandomycin (HOS-090575) ritonavir (HOS-084521) ganciclovir (HOS-085194) paritaprevir (HOS-110301) acyclovir (HOS-088527) posaconazole (HOS-085622) idelalisib (HOS-116811)