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Drug Interactions between Agenerase and gadobenate dimeglumine

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

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Interactions between your drugs

Moderate

amprenavir gadobenate dimeglumine

Applies to: Agenerase (amprenavir) and gadobenate dimeglumine

MONITOR: Gadobenate dimeglumine may compete with other substrates of the canalicular multispecific organic anion transporter, also known as cMOAT or MRP2, which is an endogenous transporter protein that works in coordination with the conjugation process to facilitate drug excretion. In solid tumor cells, overexpression of MRP2 confers resistance to a wide variety of anticancer chemotherapeutic agents. Substrates of MRP2 include anthracyclines, protease inhibitors, taxanes, vinca alkaloids, cisplatin, etoposide, methotrexate, and tamoxifen. Theoretically, competition for MRP2 transport may interfere with the clearance of these drugs and/or gadobenate dimeglumine. In patients with tumor cell lines that express MRP2, the interaction may also result in enhanced pharmacologic response to some chemotherapeutic agents.

MANAGEMENT: Caution is advised during concomitant use of gadobenate dimeglumine and other substrates of MRP2. Patients should be monitored for potentially increased pharmacologic effects of gadobenate dimeglumine as well as the coadministered drug(s).

References (2)
  1. Huisman MT, Smit JW, Crommentuyn KM, et al. (2002) "Multidrug resistance protein 2 (MRP2) transports HIV protease inhibitors, and transport can be enhanced by other drugs." AIDS, 16, p. 2295-2301
  2. (2005) "Product Information. Multihance (gadobenate dimeglumine)." Bracco Diagnostics Inc

Drug and food interactions

Moderate

amprenavir food

Applies to: Agenerase (amprenavir)

GENERALLY AVOID: Administration with a high-fat meal may decrease the oral bioavailability of amprenavir. The mechanism is unknown. In healthy volunteers, consumption of a standardized high-fat meal decreased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of amprenavir (1200 mg single oral dose) by 36% and 21%, respectively, compared to administration in the fasted state. The time to reach Cmax (Tmax) was increased 44% following a high-fat meal.

Grapefruit juice does not appear to significantly affect the pharmacokinetics of amprenavir. In 12 healthy volunteers, administration with grapefruit juice (200 mL) decreased the mean peak plasma concentration (Cmax) of amprenavir (1200 mg single oral dose) by 22% compared to water. The median time to reach Cmax (Tmax) was prolonged from 0.75 to 1.13 hours. These pharmacokinetic changes are not thought to be clinically significant, since antiretroviral response is more closely associated with systemic exposure (AUC) and trough plasma concentration (Cmin), which were not affected in the study.

MANAGEMENT: Amprenavir may be taken with or without food, but should not be taken with a high-fat meal.

References (2)
  1. (2001) "Product Information. Agenerase (amprenavir)." Glaxo Wellcome
  2. Demarles D, Gillotin C, Bonaventure-Paci S, Vincent I, Fosse S, Taburet AM (2002) "Single-dose pharmacokinetics of amprenavir coadministered with grapefruit juice." Antimicrob Agents Chemother, 46, p. 1589-1590

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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