Cardioquin and Pirfenidone

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.

QuiNIDine may increase the blood levels of pirfenidone. In some cases, this can increase the risk and/or severity of side effects such as liver problems, sensitivity to sunlight, rash, dizziness, diarrhea, nausea, vomiting, and upset stomach. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should 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, light colored stools, 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.

MONITOR: Coadministration with moderate or potent inhibitors of CYP450 2C9, 2C19, 2D6, and/or 2E1 may increase the plasma concentrations of pirfenidone, especially when used in addition to a moderate or potent CYP450 1A2 inhibitor. Pirfenidone is primarily (70% to 80%) metabolized by CYP450 1A2, with minor contribution from CYP450 2C9, 2C19, 2D6, and 2E1. In 25 healthy nonsmokers and 25 smokers who were administered a single dose of pirfenidone with the potent CYP450 1A2 inhibitor fluvoxamine (50 mg at bedtime for 3 days; 50 mg twice a day for 3 days; then 50 mg in the morning and 100 mg at bedtime for 4 days), pirfenidone systemic exposure (AUC) increased approximately 4-fold in nonsmoking subjects and 7-fold in smoking subjects. Fluvoxamine also inhibits CYP450 2C9, 2C19 and 2D6, although the extent to which these effects contribute to the interaction has not been established. The interaction has not been studied with specific inhibitors of other isoenzymes involved in the metabolism of pirfenidone.

MANAGEMENT: Concomitant use of pirfenidone with moderate or potent inhibitors of CYP450 2C9, 2C19, 2D6, and/or 2E1 in addition to a moderate or potent inhibitor of CYP450 1A2 (e.g., certain fluoroquinolones, oral contraceptives, deferasirox, methoxsalen, mexiletine, thiabendazole, ticlopidine, zileuton) should be avoided. No particular precaution is necessary if pirfenidone and CYP450 2C9, 2C19, 2D6, and/or 2E1 inhibitors are coadministered without a moderate or potent CYP450 1A2 inhibitor.

Cardioquin

Generic Name: quinidine

Brand name: Quin-G, Cardioquin, Quinora, Quinidex Extentabs, Quinaglute Dura-Tabs, Quin-Release

Synonyms: n.a.

What is Cardioquin?

Pirfenidone

Generic Name: pirfenidone

Brand name: Esbriet

Synonyms: n.a.

What is Pirfenidone?