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Micardis and Neoral

Determining the interaction of Micardis and Neoral and the possibility of their joint administration.

Check result:
Micardis <> Neoral
Relevance: 28.12.2022 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:

Using cycloSPORINE together with telmisartan may increase potassium levels in the blood. High levels of potassium can develop into a condition known as hyperkalemia, which in severe cases can lead to kidney failure, muscle paralysis, irregular heart rhythm, and cardiac arrest. You may be more likely to develop hyperkalemia while using these medications if you are elderly, dehydrated, or have kidney disease, diabetes, or advanced heart failure. Regular or long-term use of nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen (Aleve) may also increase your risk. It is important that you maintain adequate fluid intake during treatment with these medications, especially if you are using them for prolonged periods. In addition, talk to your doctor to see if you should limit consumption of potassium-rich foods such as tomatoes, raisins, figs, potatoes, lima beans, bananas, plantains, papayas, pears, cantaloupes, mangoes, and potassium-containing salt substitutes. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should seek medical attention if you experience nausea, vomiting, weakness, confusion, tingling of the hands and feet, feelings of heaviness in the legs, a weak pulse, or a slow or irregular heartbeat, as these may be symptoms of hyperkalemia. Also contact your doctor if you develop symptoms that may suggest kidney damage such as loss of appetite, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, shortness of breath, muscle cramps, tiredness, weakness, dizziness, and irregular heart rhythm. 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 ACE inhibitors or angiotensin II receptor antagonists may increase the risk of hyperkalemia or precipitate acute renal failure. Cyclosporine causes afferent arteriolar vasoconstriction and decreased glomerular filtration. These effects may be significant when combined with ACE inhibitors or angiotensin II receptor antagonists, which block the mechanism that maintains glomerular filtration rate by constricting the efferent arterioles.

MANAGEMENT: Serum potassium levels and renal function should be checked regularly when cyclosporine is used in combination with ACE inhibitors or angiotensin II receptor antagonists. Particular caution is warranted in patients with renal impairment, diabetes, old age, severe or worsening heart failure, or dehydration. Patients should be advised to seek medical attention if they experience signs and symptoms of hyperkalemia such as nausea, vomiting, weakness, listlessness, tingling of the extremities, paralysis, confusion, weak pulse, and a slow or irregular heartbeat.

References
  • Murray BM, Venuto RC, Kohli R, Cunningham EE "Enalapril-associated acute renal failure in renal transplants: possible role of cyclosporine." Am J Kidney Dis 16 (1990): 66-9
  • Cerner Multum, Inc. "Australian Product Information." O 0
  • Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  • "Product Information. Neoral Soft Gelatin Capsules (cyclosporine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  • Perazella MA "Drug-induced hyperkalemia: old culprits and new offenders." Am J Med 109 (2000): 307-14
Micardis

Generic Name: telmisartan

Brand name: Micardis

Synonyms: n.a.

Neoral

Generic Name: cyclosporine

Brand name: Gengraf, Neoral, Sandimmune, Sandimmune

Synonyms: Neoral (Capsules, Modified)

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