Gengraf (Cyclosporine Capsules, Modified) and Solurex injection
Determining the interaction of Gengraf (Cyclosporine Capsules, Modified) and Solurex injection and the possibility of their joint administration.
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 dexamethasone may alter the blood levels and effects of both medications. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. 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 of cyclosporine with a corticosteroid may result in altered (usually elevated) plasma concentrations of one or both drugs. Cyclosporine and corticosteroids undergo metabolism primarily by CYP450 3A4, thus competitive inhibition of metabolic clearance may occur during concomitant use. Plasma prednisolone concentrations have been reported to increase during coadministration with cyclosporine in transplant patients, resulting in symptoms of hypercorticism. Similarly, trough plasma levels of cyclosporine increased following the addition of methylprednisolone in a group of patients treated for transplant rejection, some of whom required a reduction in cyclosporine dosage. There have also been isolated reports of seizures in patients receiving cyclosporine with high-dose methylprednisolone, although a causal relationship has not been established. Clinical data are not available for other corticosteroids. While all corticosteroids are believed to be substrates of CYP450 3A4 and may be competitive inhibitors of cyclosporine metabolism, dexamethasone has also been reported to induce this isoenzyme, thus it may reduce levels of cyclosporine.
MANAGEMENT: Caution is advised during concomitant therapy with cyclosporine and corticosteroids. Pharmacologic responses and/or plasma drug levels should be monitored more closely whenever one or the other agent is added to or withdrawn from therapy in patients stabilized on their existing therapeutic regimen, and the dosage(s) adjusted as necessary. During concomitant therapy, patients should be observed for symptoms of hypercorticism (e.g., acne, bruising easily, moon face, edema, hirsutism, buffalo hump, skin striae) and cyclosporine toxicity (e.g., renal dysfunction, hypertension, convulsions, tremors).
- Langhoff E, Madsen S, Flachs H, et al "Inhibition of prednisolone metabolism by cyclosporine in kidney-transplanted patients." Transplantation 39 (1985): 107-9
- Ost L "Effects of cyclosporin on prednisolone metabolism." Lancet 1 (1984): 451
- Klintmalm G, Sawe J "High dose methylprednisolone increases plasma cyclosporin levels in renal transplant recipients." Lancet 1 (1984): 731
- Durrant S, Chipping PM, Palmer S, Gordon-Smith EC "Cyclosporin A, methylprednisolone, and convulsions." Lancet 2 (1982): 829-30
Generic Name: cyclosporine
Brand name: Gengraf, Neoral, Sandimmune, Sandimmune
Synonyms: Gengraf (Capsules, Modified), Gengraf
Generic Name: dexamethasone
Brand name: De-Sone LA, Dexacen-4, Dexasone, Dexasone LA, Solurex, Solurex LA, Baycadron, Dexamethasone Intensol, DexPak 10 Day Taperpak, DexPak 13 DayTaperpak, DexPak 6 DayTaperpak, Decadron, DexPak, TaperDex, Zema-Pak, ZoDex, Zonacort
Synonyms: Solurex (injection)
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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