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AccessPak for HIV PEP Expanded with Kaletra and Tolvaptan (Jynarque/Jinarc)

Determining the interaction of AccessPak for HIV PEP Expanded with Kaletra and Tolvaptan (Jynarque/Jinarc) and the possibility of their joint administration.

Check result:
AccessPak for HIV PEP Expanded with Kaletra <> Tolvaptan (Jynarque/Jinarc)
Relevance: 08.06.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using tolvaptan together with ritonavir is not recommended. Combining these medications may significantly increase the blood levels and effects of tolvaptan. Serious nervous system side effects such as difficulty swallowing, trouble speaking, muscle weakness, trouble controlling body movements, confusion, mood changes, seizures, and coma may occur due to too rapid correction of salt levels in the blood. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

CONTRAINDICATED: Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of vasopressin receptor antagonists conivaptan and tolvaptan, both of which are almost exclusively metabolized by the isoenzyme. According to the product labeling, administration of oral conivaptan 10 mg in combination with 200 mg of the potent CYP450 3A4 inhibitor ketoconazole resulted in 4- and 11-fold increases in conivaptan peak plasma concentration (Cmax) and systemic exposure (AUC), respectively, compared to administration alone. Similarly, when a single 30 mg oral dose of tolvaptan was administered to 19 healthy volunteers following pretreatment with ketoconazole 200 mg/day for 3 days, tolvaptan Cmax increased by 3.5-fold and AUC increased by 5.4-fold, although 24-hour urine output increased by just 1.3-fold due to the saturable nature of tolvaptan's effect on urinary excretion rate.

MANAGEMENT: Concomitant use of conivaptan or tolvaptan with potent CYP450 3A4 inhibitors is considered contraindicated.

References
  • "Product Information. Vaprisol (conivaptan)." Cumberland Pharmaceuticals Inc, Nashville, TN.
  • "Product Information. Samsca (tolvaptan)." Otsuka American Pharmaceuticals Inc, Rockville, MD.
AccessPak for HIV PEP Expanded with Kaletra

Generic Name: emtricitabine / lopinavir / ritonavir / tenofovir

Brand name: AccessPak for HIV PEP Expanded with Kaletra

Synonyms: n.a.

Tolvaptan (Jynarque/Jinarc)

Generic Name: tolvaptan

Brand name: Samsca, Jynarque

Synonyms: Tolvaptan

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.