Wirkstoffe & Arzneimittelsicherheit

Wechselwirkungen · Modigraf

Modigraf 0.2 mg granules for oral suspension Modigraf 1 mg granules for oral suspension · Abschnitt 4.5 · PDF-Seite 11–12

HOS-209751 · Präparat HOS-154375

11 Drug/Substance Class or Drug interaction effect Recommendations concerning co- Name administration The effect on tacrolimus blood concentrations may remain for several days after co-administration is completed. Moderate or weak CYP3A4 May increase tacrolimus Monitor tacrolimus whole blood inhibitors: whole blood trough trough concentrations frequently, antifungal agents (e.g., concentrations and increase starting within the first few days fluconazole, isavuconazole, the risk of serious adverse of co-administration. Reduce clotrimazole, miconazole), reactions (e.g., neurotoxicity, tacrolimus dose if needed [see the macrolide antibiotics QT prolongation) [see section 4.2]. Monitor renal (e.g., azithromycin), calcium section 4.4]. A rapid increase function, ECG for QT channel blockers (e.g., in tacrolimus level may prolongation, and other side nifedipine, nicardipine, occur. effects closely. diltiazem, verapamil), amiodarone, danazol, ethinylestradiol, lansoprazole, omeprazole, the HCV antivirals elbasvir/grazoprevir and glecaprevir/pibrentasvir, the CMV antiviral letermovir, and the tyrosine kinase inhibitors nilotinib, crizotinib and imatinib and (Chinese) herbal remedies containing extracts of Schisandra sphenanthera In vitro the following May increase tacrolimus Monitor tacrolimus whole blood substances have been shown whole blood trough trough concentrations and reduce to be potential inhibitors of concentrations and increase tacrolimus dose if needed [see tacrolimus metabolism: the risk of serious adverse section 4.2]. bromocriptine, cortisone, reactions (e.g., neurotoxicity, Monitor renal function, ECG for dapsone, ergotamine, QT prolongation) [see QT prolongation, and other side gestodene, lidocaine, section 4.4]. effects closely. mephenytoin, midazolam, nilvadipine, norethisterone, quinidine, tamoxifen Strong CYP3A4 inducers: May decrease tacrolimus It is recommended that rifampicin, phenytoin whole blood trough concomitant use should be carbamazepine, apalutamide, concentrations and increase avoided. If unavoidable, patients enzalutamide, mitotane or St. the risk of rejection [see may require an increase in John’s wort (Hypericum section 4.4]. tacrolimus dose. Changes in perforatum) Maximal effect on tacrolimus tacrolimus dose should be blood concentrations may be individualized and adjusted as achieved 1-2 weeks after co- needed based on tacrolimus administration. The effect trough concentrations, which may remain 1-2 weeks after should be assessed at initiation, completion of the treatment. monitored frequently throughout (starting within the first few days) and re-evaluated on and after completion of the CYP3A4 inducer. After use of the CYP3A4 inducer has ended, tacrolimus

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RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): lansoprazole (HOS-085166) letermovir (HOS-090621) diltiazem (HOS-086288) elbasvir (HOS-108814) isavuconazole (HOS-085186) nifedipine (HOS-086289) cortisone (HOS-114161) nicardipine (HOS-090619) pibrentasvir (HOS-086298) lidocaine (HOS-108866) carbamazepine (HOS-085618) crizotinib (HOS-116818) apalutamide (HOS-086212) tamoxifen (HOS-088380) quinidine (HOS-085593) glecaprevir (HOS-086297) azithromycin (HOS-088112) clotrimazole (HOS-090574) mephenytoin (HOS-109801) calcium (HOS-085615) imatinib (HOS-110212) grazoprevir (HOS-108815) danazol (HOS-085473) mitotane (HOS-112479) fluconazole (HOS-087945) bromocriptine (HOS-090620) nilvadipine (HOS-116826) gestodene (HOS-116824) ergotamine (HOS-086154) amiodarone (HOS-085596) tyrosine (HOS-108875) dapsone (HOS-088141) phenytoin (HOS-084531) enzalutamide (HOS-116829) nilotinib (HOS-086218) miconazole (HOS-115630) midazolam (HOS-086167) omeprazole (HOS-085912) verapamil (HOS-090602)