Mycelex Troche and Rapamune Tablets

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.

Clotrimazole may significantly increase the blood levels of sirolimus. This may increase the risk of serious side effects such as kidney problems, hyperkalemia (high potassium levels in the blood), high blood pressure, heart failure, infections, and various types of malignancies including lymphoma and skin cancer. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you develop signs and symptoms of infection such as fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. Also seek immediate medical attention if you experience signs and symptoms that may suggest kidney damage such as nausea, vomiting, loss of appetite, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, shortness of breath, muscle cramps, tiredness, weakness, dizziness, confusion, 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.

MONITOR CLOSELY: Coadministration with clotrimazole may significantly increase the oral bioavailability of sirolimus and tacrolimus. The proposed mechanism is clotrimazole inhibition of sirolimus and tacrolimus metabolism via intestinal CYP450 3A4. In 17 post-transplant patients treated with clotrimazole troches (10 mg three times a day), significantly higher blood tacrolimus trough levels were observed by the third day compared to 18 patients treated with nystatin (5 mL four times a day). Levels were still higher in the clotrimazole group by day 7, although mean tacrolimus doses were significantly lower than in the nystatin group. The interaction has not been reported with sirolimus, although it should be expected based on its similar pharmacokinetic profile to tacrolimus.

MANAGEMENT: Caution is advised if sirolimus or tacrolimus is prescribed with clotrimazole. Immunosuppressant blood levels should be closely monitored and the dosage adjusted accordingly, particularly following initiation, discontinuation, or change of dosage of clotrimazole in patients who are stabilized on their antirejection regimen.

Mycelex Troche

Generic Name: clotrimazole

Brand name: Mycelex Troche

Synonyms: n.a.

What is Mycelex Troche?

Rapamune Tablets

Generic Name: sirolimus

Brand name: Rapamune

Synonyms: Sirolimus

What is Rapamune Tablets?