Envarsus XR and Prevymis

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.

Letermovir may significantly increase the blood levels of tacrolimus. This may increase the risk of serious side effects such as infections, lymphoma and other cancers, diabetes, kidney problems, nervous system disorders (mental status changes, seizures, visual disturbances, tremors, abnormal sensations such as burning, pricking, tingling or numbness), high blood pressure, heart problems (myocardial hypertrophy, irregular heart rhythm), and high blood levels of potassium. High levels of potassium can develop into a condition known as hyperkalemia, which in severe cases can lead to kidney failure, muscle paralysis, irregular heart rhythm, and cardiac arrest. 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. 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. You should also seek medical attention if you experience nausea, vomiting, loss of appetite, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, muscle cramps, tiredness, weakness, dizziness, confusion, tingling of the hands and feet, feelings of heaviness in the legs, a weak pulse, or a slow or irregular heartbeat, as these may be signs and symptoms of kidney problems or hyperkalemia. 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 CLOSELY: Coadministration with letermovir may significantly increase the plasma concentrations of tacrolimus. The proposed mechanism is letermovir inhibition of intestinal and hepatic CYP450 3A4, the isoenzyme responsible for the metabolic clearance of tacrolimus. According to the product labeling, tacrolimus peak plasma concentration (Cmax), systemic exposure (AUC) and concentration at 24 hours postdose (C24hr) increased by an average of 1.6-, 2.4- and 2.5-fold, respectively, when a single 5 mg dose of tacrolimus was coadministered with letermovir 480 mg orally once daily. An increased risk of nephro- and neurotoxicity, as well as other adverse effects associated with tacrolimus such as malignancies, infections, diabetes, hyperkalemia, hypertension and QT prolongation, may occur. Tacrolimus had no effect on the pharmacokinetics of letermovir.

MANAGEMENT: Caution is advised when tacrolimus is used with letermovir. Tacrolimus blood levels and renal function should be checked frequently and the dosage adjusted accordingly, particularly following initiation or discontinuation of letermovir. Patients should be advised to seek medical attention if they experience adverse effects such as fever, infection, diarrhea, tremor, decreased urination, headache, paresthesia, seizures, and changes in motor function, mental status, or sensory function.

Envarsus XR

Generic Name: tacrolimus

Brand name: Envarsus XR, Astagraf XL, Prograf, Hecoria

Synonyms: n.a.

What is Envarsus XR?

Prevymis

Generic Name: letermovir

Brand name: Prevymis

Synonyms: n.a.

What is Prevymis?