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PCE Dispertab and Savaysa

Determining the interaction of PCE Dispertab and Savaysa and the possibility of their joint administration.

Check result:
PCE Dispertab <> Savaysa
Relevance: 03.12.2022 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:

Erythromycin may increase the blood levels of edoxaban. This can increase the risk of serious or life-threatening bleeding complications. 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. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. 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:

ADJUST DOSE: Coadministration with inhibitors of P-glycoprotein (P-gp) may increase the plasma concentrations of edoxaban, which is a substrate of the efflux transporter. In healthy volunteers, single-dose edoxaban systemic exposure (AUC) increased approximately 80% to 90% by erythromycin, dronedarone, and ketoconazole; 70% to 80% by cyclosporine and quinidine; 50% by verapamil; and 40% by amiodarone. The peak plasma concentration (Cmax) of edoxaban also increased by approximately 45% to 90% with these drugs.

MANAGEMENT: When used for the treatment of deep vein thrombosis and pulmonary embolism, the manufacturer recommends that edoxaban dosage be reduced to 30 mg once daily in patients receiving concomitant treatment with certain P-gp inhibitors including azithromycin, clarithromycin, erythromycin, oral itraconazole, oral ketoconazole, quinidine, and verapamil. This dosage recommendation is based on data from a clinical study, the Hokusai VTE study, and is limited to use with the specific P-gp inhibitors mentioned. Other P-gp inhibitors were not permitted in the study, and patients on antiretroviral therapy (ritonavir, nelfinavir, indinavir, saquinavir) as well as cyclosporine were excluded from the study. Following discontinuation of the P-gp inhibitor, edoxaban dosage should be returned to the regular dosage of 60 mg once daily. No dosage adjustment is recommended for edoxaban when used in the treatment of nonvalvular atrial fibrillation.

References
  • "Product Information. Savaysa (edoxaban)." Daiichi Sankyo, Inc., Parsippany, NJ.
  • Parasrampuria DA, Mendell J, Shi M, Matsushima N, Zahir H, Truitt K "Edoxaban drug–drug interactions with ketoconazole, erythromycin, and cyclosporine." Br J Clin Pharmacol 0 (2016): epub
  • Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  • Mendell J, Zahir H, Matsushima N, et al. "Drug-Drug Interaction Studies of Cardiovascular Drugs Involving P-Glycoprotein, an Efflux Transporter, on the Pharmacokinetics of Edoxaban, an Oral Factor Xa Inhibitor." Am J Cardiovasc Drugs (2013):
PCE Dispertab

Generic Name: erythromycin

Brand name: EES. Granules, EES-400 Filmtab, EryPed 200, EryPed 400, Ery-Tab, Erythrocin Lactobionate, Erythrocin Stearate Filmtab, PCE Dispertab, E. E. S, EryPed, Erythrocin, Erythromycin Filmtabs, Erythromycin Lactobionate - IV

Synonyms: PCE Dispertab (Oral), PCE, PCE (Oral)

Savaysa

Generic Name: edoxaban

Brand name: Savaysa

Synonyms: n.a.

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