Canakinumab Subcutaneous and Prograf (Tacrolimus Capsules)
Determining the interaction of Canakinumab Subcutaneous and Prograf (Tacrolimus Capsules) and the possibility of their joint administration.
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 canakinumab together with tacrolimus may increase the risk of serious infections. In addition, canakinumab may decrease the blood levels and effects of tacrolimus. You may need a dose adjustment if you have been receiving tacrolimus and are starting treatment with canakinumab. Likewise, if you have been receiving both medications, the dose of tacrolimus may need to be adjusted if canakinumab is discontinued. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the interaction, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. Contact your doctor immediately if you develop signs and symptoms of infection such as fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. 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: The use of interleukin blockers with other immunosuppressive or myelosuppressive agents may increase the risk of infections.
MANAGEMENT: Concomitant use of interleukin blockers with other immuno- or myelosuppressive agents should be avoided if possible.
MONITOR: Plasma concentrations of drugs that are CYP450 substrates may decrease following the initiation of interleukin inhibitors in patients with chronic inflammatory diseases. Because the formation of hepatic CYP450 enzymes is down-regulated during infection and chronic inflammation by increased levels of certain cytokines (e.g., interleukins-1, -6, and -10; tumor necrosis factor alpha; interferons), treatment with interleukin inhibitors may restore or normalize CYP450 enzyme levels resulting in increased metabolism of these drugs. In vitro studies showed that tocilizumab, an inhibitor of interleukin-6, has the potential to impact expression of various hepatic microsomal enzymes including CYP450 1A2, 2B6, 2C9, 2C19, 2D6, and 3A4. Its effects on CYP450 2C8 or transporters is unknown. In vivo studies with omeprazole (a substrate of CYP450 2C19 and 3A4) and simvastatin (a substrate of CYP450 3A4) showed decreases of up to 28% and 57% in systemic exposure, respectively, one week following a single dose of tocilizumab. A role for other interleukins such as IL-12, IL-17A, or IL-23 in the regulation of CYP450 enzymes has not been established, and it is not known whether antagonists of these interleukins (e.g., ixekizumab, secukinumab, ustekinumab) would similarly affect CYP450 metabolism.
MANAGEMENT: Caution is advised when interleukin inhibitors are prescribed to patients receiving concomitant drugs that are CYP450 substrates, particularly those with narrow therapeutic ranges such as immunosuppressants or antineoplastic agents. Clinical and/or laboratory monitoring should be considered following the initiation or withdrawal of interleukin inhibitor therapy, and the dosage(s) of these drugs adjusted accordingly. Clinicians should note that the effects of interleukin inhibitors on CYP450 activities may persist for several weeks after stopping therapy.
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Generic Name: canakinumab
Brand name: Ilaris
Synonyms: Canakinumab
Generic Name: tacrolimus
Brand name: Prograf, Astagraf XL, Envarsus XR, Hecoria
Synonyms: Prograf
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.
- Canakinumab Subcutaneous-Prograf (Tacrolimus Granules for Suspension)
- Canakinumab Subcutaneous-Prograf (Tacrolimus Injection)
- Canakinumab Subcutaneous-Prograf Intravenous
- Canakinumab Subcutaneous-Prohance
- Canakinumab Subcutaneous-ProHance Injection
- Canakinumab Subcutaneous-Prohist LQ
- Prograf (Tacrolimus Capsules)-Canasa
- Prograf (Tacrolimus Capsules)-Canasa Pac rectal
- Prograf (Tacrolimus Capsules)-Canasa rectal
- Prograf (Tacrolimus Capsules)-Cancidas
- Prograf (Tacrolimus Capsules)-Candesartan
- Prograf (Tacrolimus Capsules)-Candesartan and Hydrochlorothiazide