Drug Interactions between Daliresp and mercaptopurine
This report displays the potential drug interactions for the following 2 drugs:
- Daliresp (roflumilast)
- mercaptopurine
Interactions between your drugs
mercaptopurine roflumilast
Applies to: mercaptopurine and Daliresp (roflumilast)
GENERALLY AVOID: The concomitant use of roflumilast with immunosuppressive agents has not been adequately studied. Roflumilast is a selective phosphodiesterase 4 (PDE4) inhibitor and a nonsteroidal anti-inflammatory agent. In experimental models and in vitro studies, roflumilast has exhibited immunomodulatory effects. Specifically, roflumilast and its active metabolite, roflumilast N-oxide, suppress the release of inflammatory mediators including leukotriene B4, reactive oxygen species, tumor necrosis factor alpha, interferon gamma, and granzyme B. Roflumilast also reduces sputum neutrophils and attenuates influx of neutrophils and eosinophils into the airways.
MANAGEMENT: According to the product labeling for roflumilast in some countries such as Canada and the U.K., concomitant use with immunosuppressive agents such as methotrexate, azathioprine, infliximab, etanercept, and systemic corticosteroids (except when used short-term, e.g., in the treatment of COPD exacerbations) should be avoided if possible. Due to a lack of clinical experience, treatment with roflumilast should not be initiated, or existing treatment should be stopped, in patients receiving immunosuppressive agents and in patients with severe acute infectious diseases, cancers (except basal cell carcinoma), or severe immunological diseases (e.g., HIV infection, multiple sclerosis, lupus erythematosus, progressive multifocal leukoencephalopathy).
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- (2011) "Product Information. Daxas (roflumilast)." Nycomed Inc
Drug and food interactions
mercaptopurine food
Applies to: mercaptopurine
ADJUST DOSING INTERVAL: Limited data suggest that food may decrease the oral bioavailability of 6-mercaptopurine (6-MP). In one study, the pharmacokinetics of 6-MP were studied on two separate occasions in seven patients. A single dose of 6-MP was administered after an overnight fast on one occasion and 15 minutes after a standard breakfast on the other. The authors reported that peak plasma levels of 6-MP were lower and took longer to reach following administration in the fed state. In addition, plasma levels were undetectable (less than 20 ng/mL) in two patients.
MANAGEMENT: Until more information is available regarding the effect of food on 6-MP absorption, it may be advisable to take 6-MP on an empty stomach 1 hour before or 2 hours after a meal.
References
- Schmidt LE, Dalhoff K (2002) "Food-drug interactions." Drugs, 62, p. 1481-502
roflumilast food
Applies to: Daliresp (roflumilast)
Food intake does not affect the total exposure to roflumilast and its pharmacologically active N-oxide metabolite, but delays the time to maximum concentration (Tmax) of roflumilast by one hour and reduces its peak plasma concentration (Cmax) by approximately 40%. The Tmax and Cmax of
roflumilast N-oxide are unaffected. Roflumilast may be taken with or without food.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- (2011) "Product Information. Daxas (roflumilast)." Nycomed Inc
- (2011) "Product Information. Daliresp (roflumilast)." Astra-Zeneca Pharmaceuticals
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
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
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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