Prograf (Tacrolimus Granules for Suspension) and Sodium Bicarbonate, Citric Acid, and Simethicone Effervescent Granule Pkt
Determining the interaction of Prograf (Tacrolimus Granules for Suspension) and Sodium Bicarbonate, Citric Acid, and Simethicone Effervescent Granule Pkt and the possibility of their joint administration.
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 sodium bicarbonate together with tacrolimus can alter the effects of tacrolimus. You should separate the times of administration of tacrolimus and sodium bicarbonate by at least two hours. Contact your doctor if your condition worsens. You may need a dose adjustment or special test 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.
Professional:ADJUST DOSING INTERVAL: Sodium bicarbonate has been reported to cause widely variable trough plasma levels and reduced blood concentrations of tacrolimus when given close to the time of administration of tacrolimus. No other details were available in the report. Based on in vitro data, the mechanism appears to involve a pH-mediated degradation of tacrolimus. A 75% loss of tacrolimus was observed within 24 hours when tacrolimus was incubated in simulated gastric fluid with sodium bicarbonate. Other antacids tested (aluminum-magnesium hydroxide, magnesium oxide, calcium carbonate) also led to loss of tacrolimus.
MANAGEMENT: Until more data are available, it may be prudent to separate the times of administration of tacrolimus and sodium bicarbonate by at least two hours.
- Venkataramanan R, Swaminathan A, Prasad T, et al "Clinical pharmacokinetics of tacrolimus." Clin Pharmacokinet 29 (1995): 404-30
- "Product Information. Prograf (tacrolimus)." Fujisawa, Deerfield, IL.
Generic Name: tacrolimus
Brand name: Prograf, Astagraf XL, Envarsus XR, Hecoria
Synonyms: Prograf
Generic Name: citric acid / simethicone / sodium bicarbonate
Brand name: EZ Gas II
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.
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