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Gengraf and PCE Dispertab

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

Check result:

Gengraf <> PCE Dispertab

Relevance: 25.08.2022 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 and effects of cycloSPORINE. You may need a dose adjustment if you have been taking cycloSPORINE and are starting treatment with erythromycin. Contact your doctor if your condition changes or if you experience increased side effects such as nausea, vomiting, diarrhea, abdominal pain, dizziness, fatigue, headache, tremors, seizures, fever, sore throat, unusual bruising or bleeding, and increased or decreased urination. 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 CLOSELY: Coadministration with macrolide antibiotics that are potent inhibitors of CYP450 3A4 may significantly increase the blood concentrations of cyclosporine, which is primarily metabolized by the isoenzyme. The risk of nephro- and neurotoxicity associated with cyclosporine may be increased. There have been numerous reports of significant increases in cyclosporine peak concentration (Cmax) and systemic exposure (AUC) and decreases in its clearance during concomitant administration with macrolide antibiotics, especially erythromycin and clarithromycin. Macrolides that may significantly inhibit CYP450 3A4 include troleandomycin, erythromycin, and clarithromycin. Azithromycin and dirithromycin are generally believed to have little effect, if any, on CYP450 3A4, although azithromycin was implicated in a single case report.

MANAGEMENT: Caution is advised if cyclosporine is used with macrolide antibiotics that are potent inhibitors of CYP450 3A4. Cyclosporine blood levels and renal function should be checked frequently and the dosage adjusted accordingly, particularly following initiation or discontinuation of macrolide therapy in patients who are stabilized on their cyclosporine regimen. Patients should be advised to notify their doctor if they experience possible signs of cyclosporine toxicity such as nausea, vomiting, diarrhea, abdominal pain, dizziness, fatigue, headache, tremors, and convulsions. Alternative antibiotics that do not interfere with cyclosporine metabolism should be considered whenever possible.

References

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Fabre I, Fabre G, Maurel P, et al "Metabolism of cyclosporin A. Interaction of the macrolide antibiotic, erythromycin, using rabbit hepatocytes and microsomal fractions." Drug Metab Dispos 16 (1988): 296-301
Knower MT, LabellaWalker K, McFadden PM, Kantrow SP, Valentine VG "Clarithromycin for safe and cost-effective reduction of cyclosporine doses in lung allograft recipients." South Med J 93 (2000): 1087-92
Nahata M "Drug interactions with azithromycin and the macrolides: an overview." J Antimicrob Chemother 37 ( Suppl (1996): 133-42
Gupta SK, Bakran A, Johnson RW, Rowland M "Cyclosporin-erythromycin interaction in renal transplant patients." Br J Clin Pharmacol 27 (1989): 475-81
Jensen CW, Flechner SM, Van Buren CT, et al. "Exacerbation of cyclosporin toxicity by concomitant administration of erythromycin." Transplantation 43 (1987): 263-70
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Kessler M, Louis J, Renoult E, et al "Interaction between cyclosporin and erythromycin in a kidney transplant patient." Eur J Clin Pharmacol 30 (1986): 633-4
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Homma S, Takahashi KI, Nihei S, Kato F, Sugihara S, Nunoda S "The successful management of respiratory complications with long-term, low-dose macrolide administration in pediatric heart transplant recipients." Int Heart J (2014):
Amsden GW "Macrolides versus azalides: a drug interaction update." Ann Pharmacother 29 (1995): 906-17
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Gengraf

Generic Name: cyclosporine

Brand name: Gengraf, Neoral, Sandimmune, Sandimmune

Synonyms: Gengraf (Capsules, Modified)

What is Gengraf?

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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