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Interactions médicamenteuses

Isavuconazole + Sirolimus

Gravité: Majeure

Isavuconazole and Sirolimus: major interaction.

Dernière mise à jour Sources: US FDA label

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Résumé

Isavuconazole, a moderate CYP3A4 inhibitor, can increase sirolimus concentrations, leading to toxicity such as hyperlipidemia, cytopenias, impaired wound healing, and infections. The size of the effect is smaller than with voriconazole or posaconazole but still clinically important and variable between patients. The isavuconazonium label recommends monitoring sirolimus concentrations.

Ce que signifie cette interaction, en termes simples

Isavuconazole and Sirolimus can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Isavuconazole belongs to Anti Fungals; Sirolimus belongs to Miscellaneous.

Niveau de preuve: Moderate

Pourquoi elle survient

Isavuconazole inhibits CYP3A4 (and P-glycoprotein), reducing the metabolism and efflux of sirolimus.

Conduite à tenir

Measure sirolimus trough before starting isavuconazole, then frequently during co-therapy, and reduce the sirolimus dose as guided by levels. Reassess levels after isavuconazole is stopped, since sirolimus may need to be increased again.

Questions à poser à votre pharmacien

  • Does the benefit of taking both outweigh the risk in my case?
  • Do I need any blood test, ECG or other check while on both?
  • What early warning signs should I watch for, and what should I do if they appear?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Références

Questions fréquentes

Can I take Isavuconazole with Sirolimus?

MediHelp rates the interaction as major. Isavuconazole and Sirolimus can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Isavuconazole, a moderate CYP3A4 inhibitor, can increase sirolimus concentrations, leading to toxicity such as hyperlipidemia, cytopenias, impaired wound healing, and infections. The size of the effect is smaller than with voriconazole or posaconazole but still clinically important and variable between patients. The isavuconazonium label recommends monitoring sirolimus concentrations.

How serious is the interaction between Isavuconazole and Sirolimus?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Measure sirolimus trough before starting isavuconazole, then frequently during co-therapy, and reduce the sirolimus dose as guided by levels. Reassess levels after isavuconazole is stopped, since sirolimus may need to be increased again.

What other medicines interact with Isavuconazole?

MediHelp also lists interactions of Isavuconazole with, for example, Carbamazepine, Efavirenz, Etravirine. The full list is on the Isavuconazole page.

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