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Flagyl 375 and Prograf (Tacrolimus Granules for Suspension)

Determining the interaction of Flagyl 375 and Prograf (Tacrolimus Granules for Suspension) and the possibility of their joint administration.

Check result:

Flagyl 375 <> Prograf (Tacrolimus Granules for Suspension)

Relevance: 26.10.2023 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 metroNIDAZOLE together with tacrolimus can increase the effects of tacrolimus. Contact your doctor if you experience fever, infection, diarrhea, tremor, headache, fatigue, lethargy, and changes in motor function, mental status, or sensory function. You may need a dose adjustment or special test 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 a nitroimidazole may increase the blood concentrations of tacrolimus. The interaction has been reported with metronidazole, and the proposed mechanism is inhibition of hepatic tacrolimus metabolism via CYP450 3A4. In one case report, the tacrolimus levels of a kidney transplant patient increased 100% nine days after the addition of metronidazole (400 mg three times a day). His serum creatinine level was also increased. Both tacrolimus and creatinine levels declined following a decrease in the dosage of tacrolimus by more than 50%. After completion of the 2-week course of metronidazole, tacrolimus levels became subtherapeutic and an increase in the tacrolimus dosage was necessary. No data are available for tinidazole.

MANAGEMENT: Caution is advised if tacrolimus is used with metronidazole. Tacrolimus blood levels and renal function should be checked frequently and the dosage adjusted accordingly, particularly following initiation or discontinuation of metronidazole therapy in patients who are stabilized on their tacrolimus regimen. Given its structural similarities to metronidazole, the same precaution may be applicable during therapy with tinidazole, although clinical data are lacking.

References

Page RL, Klem PM, Rogers C "Potential elevation of tacrolimus trough concentrations with concomitant metronidazole therapy." Ann Pharmacother 39 (2005): 1109-13
"Product Information. Tindamax (tinidazole)." Presutti Laboratories Inc, Arlington Heights, IL.
Herzig K, Johnson DW "Marked elevation of blood cyclosporine and tacrolimus levels due to concurrent metronidazole therapy." Nephrol Dial Transplant 14 (1999): 521-3
"Product Information. Flagyl (metronidazole)." Searle, Skokie, IL.

Flagyl 375

Generic Name: metronidazole

Brand name: FIRST Metronidazole, Flagyl, Flagyl 375, MetroGel

Synonyms: Flagyl 375 Capsules

What is Flagyl 375?

Prograf (Tacrolimus Granules for Suspension)

Generic Name: tacrolimus

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

Synonyms: Prograf

What is Prograf (Tacrolimus Granules for Suspension)?

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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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