Oncovin and Procardia XL

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.

NIFEdipine may increase the blood levels and effects of vinCRIStine. 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. You should seek medical attention if you experience increased side effects of vinCRIStine such as constipation, abdominal pain or bloating, difficulty urinating, numbness or tingling in hands and feet, muscle weakness, difficulty walking, hearing loss, seizures, unusual or excessive bleeding, easy bruising, paleness, fatigue, fainting, infection, fever, chills, sore throat, or other flu-like symptoms. 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 nifedipine may increase the plasma concentrations of vincristine. The mechanism of interaction has not been described, but may involve competitive inhibition of CYP450 3A4 isoenzyme and/or P-glycoprotein efflux transporter. In one study, administration of a single 2 mg intravenous dose of vincristine in twelve patients on day 4 of nifedipine treatment (10 mg three times daily for 10 days) resulted in a nearly 70% decrease in vincristine clearance and 3.5-fold increase in systemic exposure (AUC) compared to administration of vincristine alone in 14 control patients. No noteworthy adverse effects were observed in the study. Inhibition of P-glycoprotein is also thought to be the mechanism for nifedipine reversal of vincristine resistance demonstrated in in-vitro and animal models. Overexpression of plasma membrane P-glycoprotein, also known as multidrug resistance protein 1 (MDR1) or ATP-binding cassette subfamily B member 1 (ABCB1), has been associated with decreased intracellular retention of vincristine and suggested as a primary cause of multidrug resistance in tumors, thus inhibition by drugs such as nifedipine may enhance the intracellular concentration and cytotoxicity of vincristine.

MANAGEMENT: Caution is advised if vincristine is used in combination with nifedipine. Close monitoring for increased adverse effects including neuro- and myelotoxicity is recommended.

Oncovin

Generic Name: vincristine

Brand name: Oncovin, Vincasar PFS

Synonyms: n.a.

What is Oncovin?

Procardia XL

Generic Name: nifedipine

Brand name: Adalat CC, Procardia, Procardia XL, Afeditab CR, Nifediac CC, Nifedical XL, Adalat

Synonyms: n.a.

What is Procardia XL?