Metozolv ODT and Tacrolimus Granules for Suspension
Determining the interaction of Metozolv ODT and Tacrolimus Granules for Suspension 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 tacrolimus together with metoclopramide may increase the effects of tacrolimus. Contact your doctor if you experience increased side effects such as fever, infection, diarrhea, tremor, headache, fatigue, or lethargy. 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.
Professional:MONITOR: Coadministration with gastrointestinal prokinetic agents such as cisapride, domperidone, and metoclopramide may increase the oral bioavailability of macrolide immunosuppressants. Because macrolide immunosuppressants are incompletely and variably absorbed following oral administration, increased gastrointestinal motility and gastric emptying can enhance delivery of the drugs to the small intestine where they are absorbed. In one case report, a patient with signs and symptoms of acute graft rejection in association with persistent subtherapeutic tacrolimus trough concentrations despite coadministration with ketoconazole as a pharmacokinetic booster experienced tacrolimus toxicity following the addition of metoclopramide for nausea and vomiting. Tacrolimus trough concentration exceeded 30 ng/ml, and the patient exhibited signs and symptoms suggestive of tacrolimus neuro- and nephrotoxicity. The authors theorized that the patient's persistent subtherapeutic tacrolimus levels may have been secondary to impaired gastric motility, and improvement of the condition by metoclopramide may have led to subsequent tacrolimus toxicity.
MANAGEMENT: Pharmacologic response, renal function, and macrolide immunosuppressant blood levels should be monitored more closely whenever a gastrointestinal prokinetic agent is added to or discontinue from therapy, and the immunosuppressant dosage adjusted as necessary. Patients should be advised to contact their physician if they experience potential signs and symptoms of macrolide immunosuppressant toxicity such as fever, infection, diarrhea, tremor, headache, fatigue, or lethargy.
- Prescott WA Jr, Callahan BL, Park JM "Tacrolimus toxicity associated with concomitant metoclopramide therapy." Pharmacotherapy 24 (2004): 532-7
- "Product Information. Rapamune (sirolimus)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
- "Product Information. Prograf (tacrolimus)." Fujisawa, Deerfield, IL.
Generic Name: metoclopramide
Brand name: Metozolv ODT, Reglan
Synonyms: n.a.
Generic Name: tacrolimus
Brand name: Astagraf XL, Envarsus XR, Prograf, Hecoria
Synonyms: Tacrolimus (oral and injection), Tacrolimus (Systemic)
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.
- Metozolv ODT-Tacrolimus Injection
- Metozolv ODT-Tacrolimus Intravenous
- Metozolv ODT-Tacrolimus oral and injection
- Metozolv ODT-Tacrolimus Oral, Intravenous
- Metozolv ODT-Tactinal
- Metozolv ODT-Tadalafil
- Tacrolimus Granules for Suspension-Metreleptin
- Tacrolimus Granules for Suspension-Metreleptin Subcutaneous
- Tacrolimus Granules for Suspension-MetroCream
- Tacrolimus Granules for Suspension-Metrocream Topical
- Tacrolimus Granules for Suspension-MetroGel
- Tacrolimus Granules for Suspension-MetroGel (Metronidazole Cream, Gel, and Lotion)