Ezetimibe and Neoral

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.

Talk to your doctor before using ezetimibe together with cycloSPORINE. Combining these medications may significantly increase the blood levels of ezetimibe. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue, particularly if you are also taking a statin-type medication. In some cases, rhabdomyolysis can cause kidney damage and even death. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications, or your doctor may prescribe alternative medications that do not interact. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment with ezetimibe, especially if these symptoms are accompanied by fever or dark colored urine. You should also 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, 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 cyclosporine may significantly increase the plasma concentrations of ezetimibe. The mechanism of interaction is unknown. In a study of eight postrenal transplant patients with mildly impaired or normal renal function (CrCl greater than 50 mL/min), concomitant administration of cyclosporine (75 to 150 mg twice daily) increased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of total ezetimibe 3.9-fold and 3.3-fold, respectively, compared to a historical healthy control population. In another study, a renal transplant patient with severe renal dysfunction who was receiving multiple medications, including cyclosporine, demonstrated a 12-fold greater exposure to total ezetimibe compared to healthy subjects. In a study with 12 healthy subjects, the administration of ezetimibe 20 mg/day for 8 days with a single dose of cyclosporine 100 mg on the seventh day, resulted in an average 15% increase in the AUC of cyclosporine AUC (range 10% decrease to 51% increase) compared to cyclosporine alone

MANAGEMENT: Caution is advised if ezetimibe is prescribed to patients receiving cyclosporine due to the potential for increased exposure to ezetimibe and altered exposure to cyclosporine. This exposure may be greater in patients with severe renal impairment. Monitoring of cyclosporine concentrations is recommended.

Ezetimibe

Generic Name: ezetimibe

Brand name: Zetia

Synonyms: n.a.

What is Ezetimibe?

Neoral

Generic Name: cyclosporine

Brand name: Gengraf, Neoral, Sandimmune, Sandimmune

Synonyms: Neoral (Capsules, Modified)

What is Neoral?