Лекарственные взаимодействия
Isavuconazole + Sirolimus
Тяжесть: Тяжёлое
Isavuconazole and Sirolimus: major interaction.
Последнее обновление Источники: US FDA label
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Кратко
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.
Что означает это взаимодействие простыми словами
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.
Почему это происходит
Isavuconazole inhibits CYP3A4 (and P-glycoprotein), reducing the metabolism and efflux of sirolimus.
Что делать
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.
О чём спросить фармацевта
- 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?
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Источники
Другие взаимодействия Isavuconazole
- Carbamazepine + Isavuconazole Противопоказано
- Efavirenz + Isavuconazole Противопоказано
- Etravirine + Isavuconazole Противопоказано
- Isavuconazole + Ketoconazole Противопоказано
- Isavuconazole + Phenobarbitone Противопоказано
- Isavuconazole + Phenytoin Противопоказано
Другие взаимодействия Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Противопоказано
- Bcg vaccine live + Sirolimus Противопоказано
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Противопоказано
- Ketoconazole + Sirolimus Противопоказано
- Levoketoconazole + Sirolimus Противопоказано
- Measles mumps and rubella vaccine live + Sirolimus Противопоказано
Частые вопросы
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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