Naldemedine Tosylate and Zithromax Intravenous

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.

Azithromycin may increase the blood levels of naldemedine in some patients. This may increase the risk of side effects and withdrawal symptoms such as sweating, tearing, runny nose, chills, diarrhea, abdominal pain, anxiety, insomnia, irritability, restlessness, and yawning. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring 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.

MONITOR: Coadministration with moderate inhibitors of CYP450 3A4 and/or moderate or potent inhibitors of P-glycoprotein (P-gp) may increase the plasma concentrations of naldemedine, which is primarily metabolized by CYP450 3A4 to nor-naldemedine and to a minor extent by UGT1A3 to naldemedine 3-G. Both metabolites have demonstrated antagonistic activity for opioid receptors, but with less potency than the parent drug. Naldemedine is also a substrate of the P-gp efflux transporter. According to the product labeling, administration of naldemedine with 200 mg once daily itraconazole, a potent CYP450 3A4 and P-gp inhibitor, increased naldemedine peak plasma concentration (Cmax) by 12% and systemic exposure (AUC) by 191% compared to naldemedine administered alone. When administered with 200 mg once daily fluconazole, a moderate CYP450 3A4 inhibitor, naldemedine Cmax and AUC increased by 38% and 90%, respectively. When administered with a single 600 mg dose of cyclosporine, a potent P-gp but weak CYP450 3A4 inhibitor, naldemedine Cmax and AUC increased by 45% and 78%, respectively. Increased exposure to naldemedine may precipitate opioid withdrawal symptoms such as hyperhidrosis, lacrimation, rhinorrhea, chills, diarrhea, abdominal pain, anxiety, insomnia, irritability, restlessness, and yawning.

MANAGEMENT: Caution is advised during concomitant use of naldemedine with moderate inhibitors of CYP450 3A4 and/or moderate or potent inhibitors of P-glycoprotein (P-gp). Patients should be closely monitored for potential opioid withdrawal symptoms as well as other adverse effects of naldemedine.

Naldemedine Tosylate

Generic Name: naldemedine

Brand name: Symproic

Synonyms: Naldemedine

What is Naldemedine Tosylate?

Zithromax Intravenous

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

What is Zithromax Intravenous?