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Drug Interactions between abacavir / lamivudine / zidovudine and peginterferon alfa-2b

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

zidovudine peginterferon alfa-2b

Applies to: abacavir / lamivudine / zidovudine and peginterferon alfa-2b

MONITOR CLOSELY: The coadministration of interferons and zidovudine (AZT) may result in severe bone marrow toxicity, most often manifested as granulocytopenia and/or thrombocytopenia. The precise mechanism is unknown. These agents are individually myelotoxic, with potentially additive or synergistic effects; interferons may also decrease the metabolism of zidovudine.

MANAGEMENT: Caution is advised if concomitant therapy is necessary, particularly with the alfa interferons. Complete blood counts, differential and platelet counts should be performed regularly and drug dosages adjusted accordingly. Patients should be advised to promptly report symptoms such as chills, fever, sore throat, pale skin, or unusual fatigue to their physician. Cessation of one or all drugs may be necessary if toxicity develops.

References

  1. Nokta M, Loh JP, Douidar SM, Ahmed AE, Pollard RB "Metabolic interaction of recombinant interferon-beta and zidovudine in AIDS patients." J Interferon Res 11 (1991): 159-64
  2. "Product Information. Intron A (interferon alfa-2b)." Schering Corporation PROD (2001):
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  4. Cerner Multum, Inc. "Australian Product Information." O 0
View all 4 references

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Drug and food interactions

Minor

zidovudine food

Applies to: abacavir / lamivudine / zidovudine

Food may have variable effects on the oral bioavailability of zidovudine. Fatty foods have been reported to decrease the rate and extent of zidovudine absorption following oral administration. In a study of 13 AIDS patients, mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of zidovudine were 2.8 and 1.4 times higher, respectively, in fasting patients than in those administered the medication with breakfast. In addition, variations in plasma zidovudine concentrations were increased when administered in the fed state. In another study of eight patients, the time to reach peak concentration (Tmax) was increased from 0.68 to 1.95 hours, and Cmax was reduced by 50% when zidovudine was administered with a liquid high-fat meal relative to fasting. Protein meals can also delay the absorption and reduce the Cmax of zidovudine, although the extent of absorption is not significantly affected. The clinical significance of these alterations, if any, is unknown. The product labeling states that zidovudine may be taken with or without food.

References

  1. Lotterer E, Ruhnke M, Trautman M, et al. "Decreased and variable systemic availability of zidovudine in patients with AIDS if administered with a meal." Eur J Clin Pharmacol 40 (1991): 305-8
  2. Unadkat JD, Collier AC, Crosby SS, et al. "Pharmacokinetics of oral zidovudine (azidothymidine) in patients with AIDS when administered with and without a high-fat meal." AIDS 4 (1990): 229-32
  3. "Product Information. Retrovir (zidovudine)." Glaxo Wellcome PROD (2001):
  4. Sahai J, Gallicano K, Garber G, et al. "The effect of a protein meal on zidovudine pharmacokinetics in HIV-infected patients." Br J Clin Pharmacol 33 (1992): 657-60
View all 4 references

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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