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Gilotrif and Zithromax IV

Determining the interaction of Gilotrif and Zithromax IV and the possibility of their joint administration.

Check result:
Gilotrif <> Zithromax IV
Relevance: 07.10.2022 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:

Azithromycin may increase the blood levels of afatinib. You may be more likely to experience side effects such as mouth sores; diarrhea, which can lead to dehydration and kidney problems if severe; skin reactions such as dryness, redness, rash, acne, peeling, or blistering; lung disorders causing breathing difficulty, shortness of breath, cough, and fever; eye problems resulting in eye pain, swelling, redness, tearing, light sensitivity, blurred vision, and other vision disturbances; liver damage indicated by symptoms such as fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark colored urine, light colored stools, and/or yellowing of the skin or eyes; and heart problems resulting in tiredness, shortness of breath (either at rest or during activities), palpitation, water retention, sudden weight gain, and swelling of the feet, ankles, or legs. Contact your doctor immediately if you develop these or other unusual symptoms. You may need a dose adjustment or more frequent monitoring by your doctor 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.

Professional:

ADJUST DOSE: Coadministration with inhibitors of P-glycoprotein (P-gp) may increase the plasma concentrations of afatinib, which is a substrate of the efflux transporter. In study subjects, oral administration of the P-gp inhibitor ritonavir (200 mg twice daily) one hour before afatinib dosing resulted in a 48% increase in afatinib systemic exposure. There was no change in afatinib exposure when ritonavir was administered simultaneously with, or 6 hours after, the afatinib dose.

MANAGEMENT: Caution is advised if afatinib is used in combination with P-gp inhibitors. Patients should be monitored for potentially increased adverse effects such as diarrhea, which may lead to dehydration with or without renal impairment; cutaneous reactions including rash, erythema, and bullous, blistering, or exfoliating lesions; interstitial lung disease such as lung infiltration, pneumonitis, acute respiratory distress syndrome, and allergic alveolitis; hepatotoxicity, which may be life-threatening or fatal; keratitis characterized by acute or worsening eye inflammation, lacrimation, light sensitivity, blurred vision, eye pain, red eye, and/or ulceration; and left ventricular dysfunction. The manufacturer recommends reducing the daily dose of afatinib by 10 mg if not tolerated. The previous dose may be resumed after discontinuation of the P-gp inhibitor as tolerated.

References
  • "Product Information. Gilotrif (afatinib)." Boehringer Ingelheim, Ridgefield, CT.
Gilotrif

Generic Name: afatinib

Brand name: Gilotrif

Synonyms: n.a.

Zithromax IV

Generic Name: azithromycin

Brand name: Zithromax, Zmax, AzaSite, Azithromycin 3 Day Dose Pack, Azithromycin 5 Day Dose Pack, Zithromax Tri-Pak, Zithromax Z-Pak, Zithromax IV

Synonyms: Zithromax

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.

Interaction with food and lifestyle
Disease interaction