Citric acid and sodium citrate and Prograf (Tacrolimus Granules for Suspension)
Determining the interaction of Citric acid and sodium citrate and Prograf (Tacrolimus Granules for Suspension) 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:Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.
Professional:In vitro data suggest that the presence of antacids may reduce the bioavailability of tacrolimus. An in vitro study showed that tacrolimus incubated in 100 mL simulated gastric fluid with the equivalent of 500 mg of various antacids resulted in loss of tacrolimus, due presumably to a pH-mediated degradation of tacrolimus. Specifically, aluminum-magnesium hydroxide caused a 14% loss of tacrolimus in 24 hours, magnesium oxide caused a 98% loss in 12 hours, and calcium carbonate caused a 30% loss in 24 hours. In contrast, aluminum hydroxide gel caused an immediate 35% loss of tacrolimus (within 2 minutes) and no further loss for 24 hours, suggesting adsorption of tacrolimus. Whether these effects occur in vivo, and to what extent, are unknown. Sodium bicarbonate has been reported to cause widely variable trough plasma levels and reduced blood concentrations of tacrolimus when given close to the time of administration of tacrolimus. No other details were available in the report. However, in a single-dose study, administration of tacrolimus with aluminum-magnesium hydroxide in healthy volunteers resulted in a 10% and 21% increase (not decrease) in tacrolimus peak concentration (Cmax) and systemic exposure (AUC), respectively, compared to administration without aluminum-magnesium hydroxide.
- Steeves M, Abdallah HY, Venkataramanan R, et al "In-vitro activation of a novel immunosuppressant, FK 506, and antacids." J Pharm Pharmacol 43 (1991): 574-7
Generic Name: citric acid / sodium citrate
Brand name: Bicitra, Cytra-2, Liqui-Dual Citra, Oracit, Shohl's Solution, Virtrate-2
Synonyms: Sodium Citrate and Citric Acid
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.
- Citric acid and sodium citrate-Prograf (Tacrolimus Injection)
- Citric acid and sodium citrate-Prograf Intravenous
- Citric acid and sodium citrate-Prohance
- Citric acid and sodium citrate-ProHance Injection
- Citric acid and sodium citrate-Prohist LQ
- Citric acid and sodium citrate-Prolensa
- Prograf (Tacrolimus Granules for Suspension)-Citric Acid, Magnesium Carbonate, and Glucono-Delta-Lactone
- Prograf (Tacrolimus Granules for Suspension)-Citric acid, magnesium oxide, and sodium picosulfate
- Prograf (Tacrolimus Granules for Suspension)-Citric acid, potassium citrate, and sodium citrate
- Prograf (Tacrolimus Granules for Suspension)-Citric Acid, Sodium Citrate, and Potassium Citrate
- Prograf (Tacrolimus Granules for Suspension)-Citroma
- Prograf (Tacrolimus Granules for Suspension)-Citrucel