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Gengraf Capsules and Lescol XL

Determining the interaction of Gengraf Capsules and Lescol XL and the possibility of their joint administration.

Check result:

Gengraf Capsules <> Lescol XL

Relevance: 22.08.2022 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:

Using cycloSPORINE together with fluvastatin may cause a dangerous side effect on your muscles. If your doctor prescribes these medications together, you may need a dose adjustment or special tests to safely use both medications. You should also watch for muscle symptoms and call the doctor if you have muscle pain, tenderness, or weakness, especially if you also have dark colored urine. 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:

ADJUST DOSE: Coadministration with cyclosporine may moderately increase the plasma concentrations of fluvastatin. The proposed mechanism is cyclosporine inhibition of the hepatic cytochrome P450 isoenzyme responsible for the metabolic clearance of fluvastatin, possibly CYP450 3A4. Severe myopathy and rhabdomyolysis have been reported with concomitant use of other HMG-CoA inhibitors and cyclosporine. In uncontrolled studies, concomitant administration with cyclosporine reportedly increased fluvastatin exposure two- to threefold. However, it should also be noted that several clinical trials have reported on the safe and effective use of fluvastatin and cyclosporine in transplant patients. Rhabdomyolysis and renal dysfunction has been reported with the use of fluvastatin alone.

MANAGEMENT: Patients should be monitored for development of adverse effects including myopathy. Some authorities recommend that the dose of fluvastatin should not exceed 20 mg twice daily when coadministered with cyclosporine. All patients receiving statin therapy should be advised to promptly report any unexplained muscle pain, tenderness or weakness, particularly if accompanied by fever, malaise and/or dark colored urine. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.

References

Austen JL, Shifrin FA, Bartucci MR, Knauss TC, Schulak JA, Hricik DE "Effects of fluvastatin on hyperlipidemia after renal transplantation: influence of steroid therapy." Ann Pharmacother 30 (1996): 1386-9
Malyszko JS, Malyszko J, Mysliwiec M "Serum lipids and hemostasis in kidney allograft recipients treated with fluvastatin (Lescol) for 3 months." Transplant Proc 32 (2000): 1344-6
Locsey L, Asztalos L, Kincses Z, Balazs G "Fluvastatin (Lescol) treatment of hyperlipidaemia in patients with renal transplants." Int Urol Nephrol 29 (1997): 95-106
Jardine A, Holdaas H "Fluvastatin in combination with cyclosporin in renal transplant recipients: a review of clinical and safety experience." J Clin Pharm Ther 24 (1999): 397-408
Corpier CL, Jones PH, Suki WN, et al. "Rhabdomyolysis and renal injury with lovastatin use. Report of two cases in cardiac transplant recipients." JAMA 260 (1988): 239-41
Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Li PKT, Mak TWL, Chan TH, Wang A, Lam CWK, Lai KN "Effect of fluvastatin on lipoprotein profiles in treating renal transplant recipients with dyslipoproteineimia." Transplantation 60 (1995): 652-6
East C, Alivizatos PA, Grundy SM, Jones PH, Farmer JA "Rhabdomyolysis in patients receiving lovastatin after cardiac transplantation." N Engl J Med 318 (1988): 47-8
"Product Information. Lescol (fluvastatin)." Novartis Pharmaceuticals, East Hanover, NJ.
Li PKT, Mak TWL, Wang AYM, Lee YT, Leung CB, Lui SF, Lam CWK, Lai KN "The interaction of fluvastatin and cyclosporin a in renal transplant patients." Int J Clin Pharmacol Ther 33 (1995): 246-8
Cerner Multum, Inc. "Australian Product Information." O 0
Norman DJ, Illingworth DR, Munson J, Hosenpud J "Myolysis and acute renal failure in a heart-transplant recipient receiving lovastatin." N Engl J Med 318 (1988): 46-7

Gengraf Capsules

Generic Name: cyclosporine

Brand name: Gengraf, Neoral, Sandimmune, Sandimmune

Synonyms: Gengraf (Capsules, Modified), Gengraf

What is Gengraf Capsules?

Lescol XL

Generic Name: fluvastatin

Brand name: Lescol, Lescol XL

Synonyms: n.a.

What is Lescol XL?

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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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