Drug search by name

Gengraf Capsules and Pravastatin

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

Check result:

Gengraf Capsules <> Pravastatin

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:

CycloSPORINE may significantly increase the blood levels of pravastatin. 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. In some cases, rhabdomyolysis can cause kidney damage and even death. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment with pravastatin or similar medications, 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.

Professional:

ADJUST DOSE: Coadministration with cyclosporine may increase the oral bioavailability of pravastatin. The proposed mechanism is cyclosporine inhibition of the intestinal efflux of pravastatin via MRP2 transporter. In studies of adult and pediatric organ transplant patients receiving immunosuppressive therapy containing cyclosporine, plasma concentrations of pravastatin were approximately 5 to 10 times higher than in control patients receiving pravastatin without cyclosporine. No significant adverse effects or elevations in plasma creatinine, liver enzymes, or creatine kinase levels were reported in the studies. In three reports involving a total of 100 post-transplant patients treated for up to two years concurrently with pravastatin 10 to 40 mg and cyclosporine, neither myopathy nor significant increases in creatine kinase levels have been observed. However, high levels of HMG-CoA reductase inhibitory activity in plasma has been associated with an increased risk of musculoskeletal toxicity. Myopathy manifested as muscle pain and/or weakness associated with grossly elevated creatine kinase exceeding ten times the upper limit of normal has been reported occasionally. Rhabdomyolysis has also occurred rarely, which may be accompanied by acute renal failure secondary to myoglobinuria and may result in death. Pravastatin does not affect the plasma concentrations of cyclosporine.

MANAGEMENT: The benefits of the use of pravastatin in combination with cyclosporine should be carefully weighed against the potential risks. Pravastatin dosage should start at 10 mg/day and generally not exceed 20 mg/day when used in combination with cyclosporine. Higher dosages should be used with caution. All patients treated with HMG-CoA reductase inhibitors should be advised to promptly report any unexplained muscle pain, tenderness, or weakness, particularly if accompanied by malaise or fever. 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

Yoshimura N, Oka T, Okamoto M, Ohmori Y "The effects of pravastatin on hyperlipidemia in renal transplant recipients." Transplantation 53 (1992): 94-9
Hedman M, Neuvonen PJ, Neuvonen M, Holmberg C, Antikainen M "Pharmacokinetics and pharmacodynamics of pravastatin in pediatric and adolescent cardiac transplant recipients on a regimen of triple immunosuppression." Clin Pharmacol Ther 75 (2004): 101-9
Park JW, Siekmeier R, Merz M, et al. "Pharmacokinetics of pravastatin in heart-transplant patients taking cyclosporin A." Int J Clin Pharmacol Ther 40 (2002): 439-50
Kobashigwa JA, Katznelson S, Laks H, et al. "Effect of pravastatin on outcomes after cardiac transplantation." N Engl J Med 333 (1995): 621-7
"Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb, Princeton, NJ.
Launay-Vacher V, Izzedine H, Deray G "Statins' dosage in patients with renal failure and cyclosporine drug-drug interactions in transplant recipient patients." Int J Cardiol 101 (2005): 9-17
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
Holtzman CW, Wiggins BS, Spinler SA "Role of P-glycoprotein in statin drug interactions." Pharmacotherapy 26 (2006): 1601-7
Regazzi MB, Iacona I, Campana C, Raddato V, Lesi C, Perani G, Gavazzi A, Vigano M "Altered disposition of pravastatin following concomitant drug therapy with cyclosporin A in transplant recipients." Transplant Proc 25 (1993): 2732-4
Southworth MR, Mauro VF "The use of HMG-CoA reductase inhibitors to prevent accelerated graft atherosclerosis in heart transplant patients." Ann Pharmacother 31 (1997): 489-91
Lill J, Bauer LA, Horn JR, Hansten PD "Cyclosporine-drug interactions and the influence of patient age." Am J Health Syst Pharm 57 (2000): 1579-84
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
Cuenca-Estrella M, Mellado E, Diaz-Guerra TM, Monzon A, Rodriguez-Tudela JL "Susceptibility of fluconazole-resistant clinical isolates of Candida spp. to echinocandin LY303366, itraconazole and amphotericin B." J Antimicrob Chemother 46 (2000): 475-7
Castelao AM, Grinyo JM, Castineiras MJ, Fiol C, Gilvernet S, Seron D, Torras J, Cruzado JM, Alsina J "Effect of pravastatin in the treatment of hypercholesterolemia after renal transplantation under cyclosporine and prednisone." Transplant Proc 27 (1995): 2217-20
Bancalari E "Caffeine for apnea of prematurity." N Engl J Med 354 (2006): 2179-81
Capone D, Stanziale P, Gentile A, Imperatore P, Pellegrino T, Basile V "Effects of simvastatin and pravastatin on hyperlipidemia and cyclosporin blood levels in renal transplant recipients." Am J Nephrol 19 (1999): 411-5
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

Gengraf Capsules

Generic Name: cyclosporine

Brand name: Gengraf, Neoral, Sandimmune, Sandimmune

Synonyms: Gengraf (Capsules, Modified), Gengraf

What is Gengraf Capsules?

Pravastatin

Generic Name: pravastatin

Brand name: Pravachol

Synonyms: n.a.

What is Pravastatin?

+ Add a drug Remove all

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.

The list of popular interactions