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Daunorubicin hydrochloride and PCE Dispertab

Determining the interaction of Daunorubicin hydrochloride and PCE Dispertab and the possibility of their joint administration.

Check result:

Daunorubicin hydrochloride <> PCE Dispertab

Relevance: 04.12.2022 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:

Erythromycin may increase the blood levels of DAUNOrubicin. This can increase the risk of side effects such as irregular heartbeat, heart failure, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. Contact your doctor if you experience potential signs and symptoms of these conditions such as paleness, fatigue, dizziness, fainting, unusual bleeding or bruising, fever, chills, sore throat, body aches, or other flu-like symptoms. You should seek immediate medical attention if you experience sudden, unexplained weight gain; swelling of the hands, ankles, or feet; chest pain; or difficulty breathing, as these may be indications of heart failure. You may need a dose adjustment or more frequent monitoring by your doctor 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:

MONITOR: Coadministration with inhibitors of P-glycoprotein (P-gp) may increase the plasma concentrations of daunorubicin and idarubicin, both of which are substrates of the efflux transporter also known as ABCB1 or MDR1. The interaction has been studied with cyclosporine, a potent P-gp inhibitor, in attempt to overcome multidrug resistance in MDR1-overexpressing tumors. In a randomized study to test whether cyclosporine can enhance the antileukemia effect of anthracyclines, cyclosporine was found to significantly reduce the frequency of resistance to induction chemotherapy consisting of sequential cytarabine and daunorubicin (31% vs. 47%). The addition of cyclosporine also increased relapse-free and overall survival, particularly in patients with moderate or high P-gp expression. Pharmacokinetically, steady-state mean serum concentrations of daunorubicin and its active metabolite, daunorubicinol, were significantly higher (approximately 2-fold and 4-fold, respectively) in patients receiving cyclosporine. Although there was no significant difference in the frequency or severity of stomatitis or renal toxicity (as measured by creatinine elevation), grade 4 hyperbilirubinemia and grade 3 nausea occurred more frequently in patients receiving cyclosporine than in controls (31% vs. 4% and 11% vs. 3%, respectively). In a pharmacokinetic study of 27 patients with acute myelogenous leukemia receiving induction chemotherapy with idarubicin and cytarabine, the systemic exposure (AUC) to idarubicin and idarubicinol was increased by 77% and 182%, respectively, in patients administered cyclosporine 10 mg/kg daily compared to controls due to a 40% reduction in total body clearance. The interaction was also reported in another study in which increases in the AUC of idarubicin and idarubicinol were associated with increased levels of toxicity.

MANAGEMENT: Caution is advised if daunorubicin or idarubicin is prescribed in combination with a P-gp inhibitor. Patients should be closely monitored for increased adverse effects including cardiotoxicity and myelosuppression.

References

"Product Information. Daunoxome (daunorubicin liposomal)." Nexstar Pharmaceuticals Inc, Boulder, CO.
"Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
"Multum Information Services, Inc. Expert Review Panel"
"Product Information. Cerubidine (daunorubicin)." Wyeth-Ayerst Laboratories, Philadelphia, PA.

Daunorubicin hydrochloride

Generic Name: daunorubicin

Brand name: Cerubidine

Synonyms: Daunorubicin, DAUNOrubicin (Conventional)

What is Daunorubicin hydrochloride?

PCE Dispertab

Generic Name: erythromycin

Brand name: EES. Granules, EES-400 Filmtab, EryPed 200, EryPed 400, Ery-Tab, Erythrocin Lactobionate, Erythrocin Stearate Filmtab, PCE Dispertab, E. E. S, EryPed, Erythrocin, Erythromycin Filmtabs, Erythromycin Lactobionate - IV

Synonyms: PCE Dispertab (Oral), PCE, PCE (Oral)

What is PCE Dispertab?

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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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