Drug interactions between Prograf and Vfend
Results for the following 2 drugs: |
|
|---|---|
| Prograf (tacrolimus) | |
| Vfend (voriconazole) | |
Interactions between your selected drugs
tacrolimus ⇔ voriconazole
Applies to: Prograf (tacrolimus) and Vfend (voriconazole)
ADJUST DOSE: Coadministration with voriconazole may increase the plasma concentrations of tacrolimus. The mechanism is voriconazole inhibition of CYP450 3A4, the isoenzyme responsible for the metabolic clearance of tacrolimus. According to the manufacturer, voriconazole (400 mg orally every 12 hours for 1 day, then 200 mg every 12 hours for 6 days) increased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of tacrolimus (0.1 mg/kg single dose) by an average of 2- and 3-fold, respectively, in healthy subjects. The interaction was also reported in a liver transplant recipient whose blood tacrolimus concentration increased nearly tenfold after receiving voriconazole.
MANAGEMENT: Caution is advised if tacrolimus must be used concomitantly with voriconazole. Patients who are already receiving tacrolimus should have the dosage reduced to one-third the original dosage upon initiation of voriconazole therapy. Close monitoring of renal function and tacrolimus blood levels is recommended both following initiation and withdrawal of voriconazole therapy, and the tacrolimus dosage adjusted as necessary.
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