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Caduet and Conivaptan Hydrochloride

Determining the interaction of Caduet and Conivaptan Hydrochloride and the possibility of their joint administration.

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Caduet <> Conivaptan Hydrochloride

Relevance: 28.09.2022 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:

Talk to your doctor before using conivaptan together with atorvastatin. Combining these medications may significantly increase the blood levels of atorvastatin. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. Your doctor may prescribe an alternative to atorvastatin while you are being treated with conivaptan, or you may need to stop taking atorvastatin until at least one week after you finish treatment with conivaptan. Always let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment with atorvastatin, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. 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:

GENERALLY AVOID: Coadministration with conivaptan may significantly increase the plasma concentrations of certain HMG-CoA reductase inhibitors and/or their pharmacologically active metabolites. The mechanism is conivaptan inhibition of CYP450 3A4 metabolism. Intravenous conivaptan 30 mg/day has been reported to cause a 3-fold increase in simvastatin systemic exposure (AUC). High levels of HMG-CoA reductase inhibitory activity in plasma (e.g., due to liver disease or interaction with other potent 3A4 inhibitors such as macrolide antibiotics and azole antifungal agents) is associated with an increased risk of musculoskeletal toxicity. Myopathy manifested as muscle pain and/or weakness associated with grossly elevated creatine kinase exceeding ten times the upper limit of normal has been reported occasionally. Rhabdomyolysis has also occurred rarely, which may be accompanied by acute renal failure secondary to myoglobinuria and may result in death. In clinical trials of oral conivaptan, two cases of rhabdomyolysis occurred in patients who were also receiving a CYP450 3A4-metabolized HMG-CoA reductase inhibitor.

MANAGEMENT: In general, lovastatin, red yeast rice (which contains lovastatin), and simvastatin should be avoided in patients treated with conivaptan due to the potential for severe interaction. Atorvastatin may possibly be used with caution, although clinical data are lacking. Patients currently receiving these agents should consider an interruption during administration of conivaptan, and allow an appropriate amount of time (at least one week) following completion of conivaptan therapy before resuming these medications. Conivaptan is not expected to interact with fluvastatin, pravastatin, and rosuvastatin, since these agents are not significantly metabolized by CYP450 3A4.

References

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Caduet

Generic Name: amlodipine / atorvastatin

Brand name: Caduet

Synonyms: n.a.

What is Caduet?

Conivaptan Hydrochloride

Generic Name: conivaptan

Brand name: Vaprisol

Synonyms: Conivaptan

What is Conivaptan Hydrochloride?

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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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