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Actiq and Sandimmune

Determining the interaction of Actiq and Sandimmune and the possibility of their joint administration.

Check result:
Actiq <> Sandimmune
Relevance: 11.04.2022 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:

CycloSPORINE can increase the blood levels and effects of fentaNYL. Contact your doctor if you experience dizziness, confusion, fainting, extreme sedation, slow heart rate, slow or difficult breathing, and shortness of breath. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. 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:

MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of fentanyl, which is primarily metabolized by the isoenzyme. Increased fentanyl concentrations could conceivably increase or prolong adverse drug effects and may cause respiratory depression.

MANAGEMENT: Patients receiving fentanyl in combination with CYP450 3A4 inhibitors should be carefully monitored, and dosage adjustments made accordingly if necessary. Patients and/or their caregivers should be advised to seek medical attention if potential signs and symptoms of toxicity occur such as dizziness, confusion, fainting, extreme sedation, bradycardia, slow or difficult breathing, and shortness of breath. Patients treated with transdermal formulations of fentanyl should be cautioned that drug interactions and drug effects may be observed for a prolonged period beyond removal of the patch, as significant amounts of fentanyl are absorbed from the skin for 17 hours or more after the patch is removed.

References
  • "Product Information. Actiq (fentanyl)." Abbott Pharmaceutical, Abbott Park, IL.
  • Tateishi T, Krivoruk Y, Ueng YF, Wood AJ, Guengerich FP, Wood M "Identification of human cytochrome P-450 3A4 as the enzyme responsible for fentanyl and sufentanil N-dealkylation." Anesth Analg 82 (1996): 167-72
  • Ibrahim AE, Feldman J, Karim A, Kharasch ED "Simultaneous Assessment of Drug Interactions with Low- and High-Extraction Opioids: Application to Parecoxib Effects on the Pharmacokinetics and Pharmacodynamics of Fentanyl and Alfentanil." Anesthesiology 98 (2003): 853-861
  • "Product Information. Duragesic Transdermal System (fentanyl)." Janssen Pharmaceutica, Titusville, NJ.
  • Labroo RB, Paine MF, Thummel KE, Kharasch ED "Fentanyl metabolism by human hepatic and intestinal cytochrome P450 3A4: implicaitons for interindividual variability in disposition, efficacy, and drug interactions." Drug Metab Dispos 25 (1997): 1072-80
Actiq

Generic Name: fentanyl

Brand name: Actiq, Abstral, Fentora, Subsys, Duragesic, Ionsys, Lazanda, Onsolis, Sublimaze

Synonyms: n.a.

Sandimmune

Generic Name: cyclosporine

Brand name: Sandimmune, Gengraf, Neoral, Sandimmune

Synonyms: Sandimmune (Injection)

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.

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