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Neoral and Verapamil Sustained-Release Capsules

Determining the interaction of Neoral and Verapamil Sustained-Release Capsules and the possibility of their joint administration.

Check result:

Neoral <> Verapamil Sustained-Release Capsules

Relevance: 28.09.2022 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 verapamil may increase the effects of cycloSPORINE and cause harm to the kidneys. Symptoms of kidney damage include swelling, weight gain, feeling short of breath, drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea and vomiting, pain in your lower back, and urinating more or less than usual or not at all. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or special tests to safely use these medications together. 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: Verapamil may inhibit the CYP450 3A4 hepatic metabolism of cyclosporine. Trough and steady state levels, and the risk of nephrotoxicity may be increased.

MANAGEMENT: Cyclosporine levels and renal function should be monitored, and dosage should be adjusted as needed and appropriate during therapy. Other calcium channel blockers that have lesser effects on cyclosporine metabolism may be considered as alternatives (e.g., amlodipine, isradipine, nifedipine, nitrendipine).

References

Jacobs U, Klein B, Klehr HU "Cumulative side effects of cyclosporine and ca antagonists: hypergalactinemia, mastadenoma, and gynecomastia." Transplant Proc 26 (1994): 3122
Sabate I, Grino J, Castelao AM, Ortola J "Evaluation of cyclosporin-verapamil interaction, with observations on parent cyclosporine and metabolites." Clin Chem 34 (1988): 2151
Yee GC, McGuire TR "Pharmacokinetic drug interactions with cyclosporin (Part I)." Clin Pharmacokinet 19 (1990): 319-32
Sketris IS, Methot ME, Nicol D, Belitsky, Knox MG "Effect of calcium-channel blockers on cyclosporine clearance and use in renal transplant patients." Ann Pharmacother 28 (1994): 1227-31
Dy GR, Raja RM, Mendez MM "The clinical and biochemical effect of calcium channel blockers in organ transplant recipients on cyclosporine." Transplant Proc 23 (1991): 1258-9
Robson RA, Fraenkel M, Barratt LJ, Birkett DJ "Cyclosporin-verapamil interaction." Br J Clin Pharmacol 25 (1988): 402-3
McTavish D, Sorkin EM "Verapamil: an updated review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in hypertension." Drugs 38 (1989): 19-76
Sketris IS, Methot ME, Nicol D, Belitsky P, Knox MG "Effect of calcium-channel blockers on cyclosporine clearance and use in renal transplant patients." Ann Pharmacother 28 (1994): 1227-31
Dawidson I, Rooth P, Fry WR, et al "Prevention of acute cyclosporine-induced renal blood flow inhibition and improved immunosuppression with verapamil." Transplantation 48 (1989): 575-80
Dawidson I, Rooth P, Alway C, et al "Verapamil prevents posttransplant delayed function and cyclosporine A nephrotoxicity." Transplant Proc 22 (1990): 1379-80
Tortorice KF, Heim-Duthoy KL, Awni WM, Rao KV, Kasiske BL "The effects of calcium channel blockers on cyclosporine and its metabolites in renal transplant recipients." Ther Drug Monit 12 (1990): 321-8
Yildiz A, Sever MS, Turkman A, Ecder T, Turk S, Akkaya V, Ark E "Interaction between cyclosporine A and verapamil, felodipine, and isradipine." Nephron 81 (1999): 117-8

Neoral

Generic Name: cyclosporine

Brand name: Gengraf, Neoral, Sandimmune, Sandimmune

Synonyms: Neoral (Capsules, Modified)

What is Neoral?

Verapamil Sustained-Release Capsules

Generic Name: verapamil

Brand name: Calan, Isoptin SR, Verelan, Isoptin, Calan SR, Isoptin IV, Covera-HS, Verelan PM

Synonyms: Verapamil

What is Verapamil Sustained-Release Capsules?

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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.

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