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Drug Interactions between calcipotriene / fluorouracil topical and imiquimod / salicylic acid / tretinoin topical

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

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Interactions between your drugs

Moderate

tretinoin topical salicylic acid topical

Applies to: imiquimod / salicylic acid / tretinoin topical and imiquimod / salicylic acid / tretinoin topical

GENERALLY AVOID: Concomitant use of retinoids and keratolytic or astringent topicals may result in excessive irritation and/or drying.

MANAGEMENT: Depending on circumstances (e.g., areas of application), concomitant use should preferably be avoided, and a rest period considered in between use of these products.

References (2)
  1. (2001) "Product Information. Retin-A (tretinoin)." Ortho McNeil Pharmaceutical
  2. (2001) "Product Information. Tazorac (tazarotene topical)." Allergan Inc
Minor

salicylic acid topical calcipotriene topical

Applies to: imiquimod / salicylic acid / tretinoin topical and calcipotriene / fluorouracil topical

Coadministration with topical lactic acid may reduce the efficacy of calcipotriene. The mechanism of this interaction has not been fully investigated but may involve calcipotriene degradation in an acidic environment induced by acidic compounds or solutions. A study evaluating the compatibility of calcipotriene 0.005% ointment with other topical agents observed significant calcipotriene degradation at 24 hours when combined with ammonium lactate lotion 12%. Additionally, the same study also observed the combination of 6% salicylic acid with calcipotriene 0.005% ointment led to an unstable mixture, resulting in complete calcipotriene degradation within 6 hours. Guidelines for the management of psoriasis and psoriatic arthritis recommend that calcipotriene should not be used concurrently with products that can alter the pH of its base. However, if multiple topical agents are required, patients should be instructed to apply medications at different times throughout the day.

References (2)
  1. patel b, siskin s, krazmien r, Lebwohl M (1998) "Compatibility of calcipotriene with other topical medications." J Am Acad Dermatol, 38, p. 1010-1
  2. Menter A, korman nj, elmets ca, et al. (2009) "Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies." J Am Acad Dermatol, 60, p. 643-59

Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Topical antineoplastics

Therapeutic duplication

The recommended maximum number of medicines in the 'topical antineoplastics' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'topical antineoplastics' category:

  • calcipotriene/fluorouracil topical
  • imiquimod/salicylic acid/tretinoin topical

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.


Report options

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.