Actoplus Met and Deferasirox Sprinkle Granules

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.

Deferasirox may increase the blood levels of pioglitazone in some patients. You may be more likely to experience hypoglycemia, or low blood sugar, when these medications are used together. Symptoms of hypoglycemia include headache, dizziness, drowsiness, nervousness, weakness, tremor, nausea, hunger, sweating, and palpitation. The risk of other serious but uncommon side effects of pioglitazone such as fluid retention, macular edema (swelling in the back of the eye), new or worsening heart failure, bone fractures, anemia, and liver problems may also be increased. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor immediately if you experience blurred vision or other visual abnormalities; excessive or rapid weight gain; swelling in the ankles or legs; shortness of breath or difficulty breathing; unusual tiredness; chest pain or tightness; or worsening of existing heart problems. You should also seek prompt medical attention if you develop signs and symptoms of liver damage such as fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, light colored stools, and yellowing of the skin or eyes. 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.

MONITOR: Coadministration with inhibitors of CYP450 2C8 may increase the plasma concentrations of pioglitazone, which is primarily metabolized by the isoenzyme. In 10 healthy volunteers given the potent CYP450 2C8 inhibitor gemfibrozil (600 mg twice daily) for two days prior to coadministration with a single 30 mg dose of pioglitazone on day 3, mean pioglitazone systemic exposure (AUC) increased by 3.4-fold and elimination half-life (T 1/2) increased from 6.5 to 15.1 hours. In two other studies of 12 and 30 healthy volunteers, gemfibrozil administered similarly increased the mean AUC of a single 15 mg dose of pioglitazone by 3.2- and 4.3-fold, respectively, and nearly tripled the mean T 1/2. When 160 mg twice daily of trimethoprim, a relatively weak CYP450 2C8 inhibitor, was given similarly in a study of 16 healthy volunteers, the mean AUC of a 15 mg dose of pioglitazone increased by 42% and T 1/2 increased from 3.9 to 5.1 hours. Likewise, administration of pioglitazone with a single 1000 mg dose of abiraterone acetate, another CYP450 2C8 inhibitor, resulted in a 46% increase in pioglitazone AUC. The interaction is subject to a high degree of interpatient variability, which may be at least partially attributable to CYP450 2C8 polymorphism.

MANAGEMENT: Given the potential for dose-related adverse events with pioglitazone, caution is advised during coadministration with CYP450 2C8 inhibitors. Close monitoring for the development of hypoglycemia and other adverse effects is recommended, such as fluid retention; weight gain; new or worsening heart failure; pulmonary, peripheral, and macular edema; bone fractures; anemia; and liver enzyme elevations. Patients should regularly monitor their blood sugar and learn how to recognize and treat hypoglycemia, which may include symptoms such as headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, and palpitation. The dosage of pioglitazone may require adjustment if an interaction is suspected. Likewise, patients should be observed for potential loss of glycemic control following discontinuation of the CYP450 2C8 inhibitor, and the pioglitazone dosage adjusted as necessary.

Actoplus Met

Generic Name: metformin / pioglitazone

Brand name: Actoplus Met, Actoplus Met XR

Synonyms: n.a.

What is Actoplus Met?

Deferasirox Sprinkle Granules

Generic Name: deferasirox

Brand name: Exjade, Jadenu, Jadenu Sprinkle

Synonyms: Deferasirox

What is Deferasirox Sprinkle Granules?