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Drug Interactions between edrophonium and Uceris

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

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Interactions between your drugs

Moderate

edrophonium budesonide

Applies to: edrophonium and Uceris (budesonide)

ADJUST DOSE: Corticosteroids and adrenocorticotropic agents may diminish the therapeutic effects of acetylcholinesterase inhibitors in myasthenia gravis. The mechanism of interaction is unknown. Marked deterioration in muscle strength has been reported in patients with myasthenia gravis shortly after the initiation of corticosteroid therapy, particularly when high dosages were used. In most cases, the decline in muscular function was relatively refractory to acetylcholinesterase inhibitors. However, clinical improvement generally occurs during prolonged corticosteroid therapy when administered properly.

MANAGEMENT: Corticosteroid therapy should be instituted at relatively low dosages (15 to 25 mg/day of prednisone or equivalent) and in a controlled setting in patients with myasthenia gravis. Respiratory support should be available, and the dosage should be increased stepwise as tolerated (approximately 5 mg/day of prednisone or equivalent at 2- to 3-day intervals until marked clinical improvement or a dosage of 50 mg/day is reached). Dose reductions of the acetylcholinesterase inhibitor may be required as symptoms improve, which often may be delayed and gradual.

References

  1. Namba T (1972) "Corticotropin therapy in patients with myasthenia gravis." Arch Neurol, 26, p. 144-50
  2. Brunner NG, Namba T, Grob D (1972) "Corticosteroids in management of severe, generalized myasthenia gravis." Neurology, 22, p. 603-10
  3. Millikan CH, Eaton LM (1951) "Clinical evaluation of ACTH and cortisone in myasthenia gravis." Neurology, 1, p. 145-52
  4. Patten BM, Oliver KL, Engel WK (1974) "Adverse interaction between steroid hormones and anticholinesterase drugs." Neurology, 24, p. 442-9
  5. Braunwald E, Hauser SL, Kasper DL, Fauci AS, Isselbacher KJ, Longo DL, Martin JB, eds., Wilson JD (1998) "Harrison's Principles of Internal Medicine." New York, NY: McGraw-Hill Health Professionals Division
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Drug and food interactions

Moderate

budesonide food

Applies to: Uceris (budesonide)

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations and systemic effects of orally administered budesonide. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. According to the manufacturer, the systemic exposure of oral budesonide approximately doubles after extensive intake of grapefruit juice.

MANAGEMENT: Patients receiving budesonide should avoid the regular consumption of grapefruits and grapefruit juice to prevent undue increases in plasma budesonide levels and systemic effects.

References

  1. (2001) "Product Information. Entocort (budesonide)." AstraZeneca Pharma 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.

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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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