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Adriamycin and Cyclosporine oral/injection

Determining the interaction of Adriamycin and Cyclosporine oral/injection and the possibility of their joint administration.

Check result:

Adriamycin <> Cyclosporine oral/injection

Relevance: 20.09.2022 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 DOXOrubicin together with cycloSPORINE may increase the effects of DOXOrubicin. Contact your doctor if you experience extreme fatigue, easy bruising or bleeding, black, bloody or tarry stools, fever, chills, irregular heartbeat, abdominal pain, yellowing of the skin or eyes, severe nausea, vomiting, diarrhea, and loss of appetite. If your doctor does prescribe these medications together, you may need a dose adjustment or special test 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:

ADJUST DOSE: Cyclosporine can significantly decrease plasma clearance both of doxorubicin and of its main metabolite, doxorubicinol. In resistant cells, intracellular accumulation of doxorubicin does not occur because the multidrug resistance-1 (MDR-1) gene product, a membrane glycoprotein, is an energy-dependent efflux pump. Cyclosporine blocks the function of this pump, allowing a greater intracellular accumulation of some cytotoxic agents.

MANAGEMENT: This interaction may be used to clinical advantage in the treatment of cancer. If cyclosporine is used to decrease tumor cell resistance to doxorubicin, it is recommended that doxorubicin dosage be reduced to approximately 50% to 60% of the normally recommended dosage.

References

Rushing DA, Raber SR, Rodvold KA, Piscitelli SC, Plank GS, Tewksbury DA "The effects of cyclosporine on the pharmacokinetics of doxorubicin in patients with small cell lung cancer." Cancer 74 (1994): 834-41
Bartlett NL, Lum BL, Fisher GA, Brophy NA, Ehsan MN, Halsey J, Sikic BI "Phase I trial of doxorubicin with cyclosporine as a modulator of multidrug resistance." J Clin Oncol 12 (1994): 835-42
Tidefelt U, Juliusson G, Elmhorn-Rosenborg A, Peterson C, Paul C "Increased intracellular concentrations of doxorubicin in resistant lymphoma cells in vivo by concomitant therapy with verapamil and cyclosporin A." Eur J Haematol 52 (1994): 276-82
Scheulen ME, Budach W, Skorzec M, Wiefelsputz JK, Seeber S "Influence of cyclosporin A on the pharmacokinetics and pharmacodynamics of doxorubicin (Meeting abstract)." Proc Annu Meet Am Assoc Cancer Res 34 (1993): a12711993
Klaff RA "The effects of cyclosporine on the pharmacokinetics of doxorubicin in patients with small cell lung cancer." Cancer 75 (1995): 1215-6
Bartlett NL, Fisher GA, Halsey J, Ehsan MN, Lum BL, Sikic BI "A Phase I trial of doxorubicin (D) with cyclosporine (CsA) as a modulator of multidrug resistance (MDR)." Proc Annu Meet Am Soc Clin Oncol 12 (1993): a366
Barbui T, Rambaldi A, Parenzan L, Zucchelli M, Perico N, Remuzzi G "Neurological symptoms and coma associated with doxorubicin administration during chronic cyclosporin therapy." Lancet 339 (1992): 1421
Larsson R, Bergh J, Nygren P "Combination of cyclosporin A and buthionine sulfoximine (BSO) as a pharmacological strategy for circumvention of multidrug resistance in small cell lung cancer cell lines selected for resistance to doxorubicin." Anticancer Res 11 (1991): 455-9
Sonneveld P, Durie BG, Lokhorst HM, Marie JP, Solbu G, et al "Modulation of multidrug-resistant multiple myeloma by cyclosporin. The Leukaemia Group of the EORTC and the HOVON." Lancet 340 (1992): 255-9
Hu XF, Martin TJ, Bell DR, de Luise M, Zalcberg JR "Combined use of cyclosporin A and verapamil in modulating multidrug resistance in human leukemia cell lines." Cancer Res 50 (1990): 2953-7
Shoji Y, Fisher MH, Periasamy A, et al "Verapamil and cyclosporin A modulate doxorubicin toxicity by distinct mechanisms." Cancer Lett 57 (1991): 209-18
Colombo T, Zucchetti M, D'Incalci M "Cyclosporin A markedly changes the distribution of doxorubicin in mice and rats." J Pharmacol Exp Ther 269 (1994): 22-7

Adriamycin

Generic Name: doxorubicin

Brand name: Adriamycin, Adriamycin RDF, Rubex, Adriamycin PFS

Synonyms: n.a.

What is Adriamycin?

Cyclosporine oral/injection

Generic Name: cyclosporine

Brand name: Gengraf, Neoral, Sandimmune, Sandimmune

Synonyms: Cyclosporine (oral/injection), CycloSPORINE (Systemic)

What is Cyclosporine oral/injection?

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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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