Gengraf Capsules and Sirolimus Oral Solution

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.

Using sirolimus together with cycloSPORINE may increase the effects of sirolimus. Sirolimus should be administered at least 4 hours after cycloSPORINE. Contact your doctor if you experience fast heart rate, fever, chills, body aches, and flu symptoms. If your doctor does prescribe these medications together, 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.

ADJUST DOSING INTERVAL: The simultaneous administration of cyclosporine and sirolimus may significantly increase plasma concentrations of the latter. The proposed mechanism is cyclosporine inhibition of P-glycoprotein, which is responsible for the active efflux of sirolimus and other drugs back into the intestinal lumen. In a randomized, crossover study of 20 kidney transplant patients receiving individualized dosages of cyclosporine (microemulsion formulation) twice a day and sirolimus once a day, concurrent administration of the morning doses of the two drugs increased sirolimus peak plasma concentrations (Cmax) by 72%, area under the concentration-time curve (AUC) by 45%, and trough concentrations by 49% compared to administration of sirolimus 4 hours after cyclosporine. No changes were observed in the pharmacokinetics of cyclosporine in the study. However, the manufacturer reports that renal transplant patients administered the two drugs 4 hours apart had decreased oral clearance of cyclosporine after 6 months, which required dosage reductions to maintain target concentrations. Pharmacodynamically, the concurrent use of these two drugs may result in additive nephrotoxicity. Patients treated with the combination were noted to have higher serum creatinine levels and lower glomerular filtration rates compared to patients treated with cyclosporine and placebo or azathioprine controls.

MANAGEMENT: The manufacturer recommends that sirolimus be administered 4 hours after a cyclosporine dose. Renal function and blood levels of both drugs should be closely monitored, and the dosages adjusted accordingly. During chronic administration, the clearance of cyclosporine may decrease and the dosage may need to be reduced to maintain target concentrations.

Gengraf Capsules

Generic Name: cyclosporine

Brand name: Gengraf, Neoral, Sandimmune, Sandimmune

Synonyms: Gengraf (Capsules, Modified), Gengraf

What is Gengraf Capsules?

Sirolimus Oral Solution

Generic Name: sirolimus

Brand name: Rapamune

Synonyms: Sirolimus

What is Sirolimus Oral Solution?