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Felodipine and Neoral

Determining the interaction of Felodipine and Neoral and the possibility of their joint administration.

Check result:

Felodipine <> Neoral

Relevance: 26.11.2022 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:

Using cycloSPORINE together with felodipine can cause damage to the kidneys or cause nerve loss. This may be more likely to occur in older adults or those with using high dosages, or preexisting kidney problems. Tell your doctor if you experience dizziness, numbness, skin tingling, muscle twitching, or seizures which may be signs of nerve damage. Talk with your doctor if you develop fever, chills, body aches, flu symptoms, severe pain in your upper stomach spreading to your back, dizziness, or headache. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or special test if you 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: Cyclosporine may significantly increase serum felodipine concentrations by inhibition of CYP450 3A4 first pass metabolism. The clinical significance of increased felodipine levels appears negligible in healthy volunteers. Felodipine may also increase cyclosporine concentrations but to a lesser extent. Serum cyclosporine concentrations and the risk of cyclosporine-induced neurotoxicity and nephrotoxicity may be increased.

MANAGEMENT: Clinical and laboratory monitoring for altered efficacy and safety (e.g., increased cyclosporine levels, excessive hypotension, or nephrotoxicity) of both drugs is recommended during concomitant therapy and when the dose of either drug is changed or discontinued. Dosage adjustments may be required. Amlodipine undergoes less first-pass metabolism and may be considered as an alternative. Patients should be advised to notify their physician if they experience nausea, vomiting, diarrhea, abdominal pain, dizziness, syncope, fatigue, or headache.

References

Sketris IS, Methot ME, Nicol D, Belitsky P, Knox MG "Effect of calcium-channel blockers on cyclosporine clearance and use in renal transplant patients." Ann Pharmacother 28 (1994): 1227-31
Jacobs U, Klein B, Klehr HU "Cumulative side effects of cyclosporine and ca antagonists: hypergalactinemia, mastadenoma, and gynecomastia." Transplant Proc 26 (1994): 3122
Madsen JK, Jensen JD, Jensen LW, Pedersen EB "Pharmacokinetic interaction between cyclosporine and the dihydropyridine calcium antagonist felodipine." Eur J Clin Pharmacol 50 (1996): 203-8
Meredith PA, Elliott HL "Clinical pharmacokinetics of amlodipine." Clin Pharmacokinet 22 (1992): 22-31
Pedersen EB, Sorensen SS, Eiskjaer H, et al "Interaction between cyclosporine and felodipine in renal transplant recipients." Kidney Int 41 (1992): s82-6
Cohen DJ, Teng SN, Appel GB "Influence of oral felodipine on serum cyclosporine concentrations." Clin Transplant 8 (1994): 541-5

Felodipine

Generic Name: felodipine

Brand name: Plendil

Synonyms: n.a.

What is Felodipine?

Neoral

Generic Name: cyclosporine

Brand name: Gengraf, Neoral, Sandimmune, Sandimmune

Synonyms: Neoral (Capsules, Modified)

What is Neoral?

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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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