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Drug Interactions between Cytovene and zalcitabine

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

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Interactions between your drugs

Minor

ganciclovir zalcitabine

Applies to: Cytovene (ganciclovir) and zalcitabine

The coadministration of ganciclovir or its prodrug, valganciclovir, with zalcitabine may result in elevated plasma concentrations of ganciclovir. In 10 asymptomatic subjects with HIV and CMV coinfection, zalcitabine (0.75 mg orally every 8 hours) increased the peak plasma concentration and area under the concentration-time curve of ganciclovir (1000 mg orally every 8 hours) by an average of 22% and 18%, respectively, although only the former was statistically significant. The mechanism is unknown. Ganciclovir had minimal effect on the pharmacokinetics of zalcitabine. This interaction is unlikely to be of clinical significance.

References

  1. Jung D, AbdelHameed MH, Teitelbaum P, Dorr A, Griffy K (1999) "The pharmacokinetics and safety profile of oral ganciclovir combined with zalcitabine or stavudine in asymptomatic HIV- and CMV-seropositive patients." J Clin Pharmacol, 39, p. 505-12
  2. (2001) "Product Information. Valcyte (valganciclovir)." Roche Laboratories

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Drug and food interactions

Moderate

ganciclovir food

Applies to: Cytovene (ganciclovir)

ADJUST DOSING INTERVAL: Food delays but enhances the oral absorption and bioavailability of ganciclovir capsules, possibly due to prolongation of gastrointestinal transit time. In 20 HIV- and CMV-seropositive subjects, ganciclovir dosing (1000 mg every 8 hours) following a standardized high-fat breakfast increased the mean steady-state peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of ganciclovir by an average of 15% and 22%, respectively, compared to dosing after an overnight fast. The time to reach peak plasma concentration (Tmax) was prolonged from 1.8 to 3 hours. In another study of 15 such patients, administration of ganciclovir (2000 mg) within 30 minutes following a high-fat breakfast increased the Cmax and AUC an average of 111% and 114%, respectively, compared to administration in the fasting state (i.e. at least 1 hour before or 2 hours after a meal or snack). Over the total day of dosing (2000 mg orally three times a day), there was a mean increase of 48% and 97% in Cmax and AUC, respectively, and a 36% decrease in half-life during administration with meals.

MANAGEMENT: To ensure maximal oral absorption, oral ganciclovir should be administered with or immediately after a meal.

References

  1. (2002) "Product Information. Cytovene (ganciclovir)." Genentech
  2. Lavelle J, Follansbee S, Trapnell CB, Buhles WC, Griffy KG, Jung D, Dorr A, Conner J (1996) "Effect of food on the relative bioavailability of oral ganciclovir." J Clin Pharmacol, 36, p. 238-41
  3. Jung D, Griffy K, Dorr A (1999) "Effect of food on high-dose oral ganciclovir disposition in HIV-positive subjects." J Clin Pharmacol, 39, p. 161-5

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Minor

zalcitabine food

Applies to: zalcitabine

Zalcitabine bioavailability may be decreased by 14% if taken with meals. The mechanism and clinical significance are unknown.

References

  1. (2001) "Product Information. HIVID (zalcitabine)." Roche Laboratories

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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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