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Drug Interactions between cilostazol and cladribine

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

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Interactions between your drugs

Moderate

cladribine cilostazol

Applies to: cladribine and cilostazol

GENERALLY AVOID: Oral bioavailability and systemic exposure of cladribine may be increased by potent inhibitors of breast cancer resistance protein (BCRP) while intracellular distribution and renal elimination of cladribine may be altered by potent inhibitors of equilibrative nucleoside transporter 1 (ENT1) and concentrative nucleoside transporter 3 (CNT3). The mechanism involves inhibition of ENT1, CNT3, and/or BCRP as cladribine is a substrate of each of these transporter systems. The clinical relevance remains unknown.

MANAGEMENT: Coadministration of potent ENT1, CNT3, or BCRP transporter inhibitors should be avoided during the 4 to 5-day oral cladribine treatment cycles. If coadministration is required, consider concomitant alternatives that exhibit no or minimal inhibition of ENT1, CNT3, or BCRP. If this is not possible, dose reduction to the minimum mandatory dose, separation in the timing of administration, and careful patient monitoring is recommended.

References

  1. (2001) "Product Information. Leustatin (cladribine)." Ortho Biotech Inc
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Cerner Multum, Inc. "Australian Product Information."

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Drug and food interactions

Moderate

cladribine food

Applies to: cladribine

ADJUST DOSING INTERVAL: Oral cladribine may increase the bioavailability of other drugs, which may increase the risk or severity of adverse reactions. Cladribine tablets may contain hydroxypropyl betadex, which could form a complex with the active ingredients of other drugs, especially agents with low solubility. The clinical relevance of this interaction remains unknown.

MANAGEMENT: Administration of oral cladribine should be separated from any other oral drug by at least 3 hours.

References

  1. (2001) "Product Information. Leustatin (cladribine)." Ortho Biotech Inc
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Cerner Multum, Inc. "Australian Product Information."

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Moderate

cilostazol food

Applies to: cilostazol

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of cilostazol. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. The extent and clinical significance are unknown. Moreover, pharmacokinetic alterations associated with interactions involving grapefruit juice are often subject to a high degree of interpatient variability.

MANAGEMENT: Until more information is available, the manufacturer recommends avoiding consumption of grapefruit juice during cilostazol therapy. Orange juice is not expected to interact with cilostazol.

References

  1. (2001) "Product Information. Pletal (cilostazol)." Otsuka American Pharmaceuticals Inc

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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.

See also

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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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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