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Drug Interactions between Chloromycetin Sodium Succinate and Corlanor

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

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Interactions between your drugs

Moderate

chloramphenicol ivabradine

Applies to: Chloromycetin Sodium Succinate (chloramphenicol) and Corlanor (ivabradine)

MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of ivabradine, which is primarily metabolized by the isoenzyme. According to the product labeling, potent CYP450 3A4 inhibitors such as ketoconazole and josamycin have been shown to increase ivabradine systemic exposure (AUC) by approximately 7- to 8-fold, and moderate CYP450 3A4 inhibitors such as diltiazem, verapamil and grapefruit juice have been shown to increase ivabradine systemic AUC by approximately 2- to 3-fold. Elevated plasma levels of ivabradine may increase the risk of excessive bradycardia and conduction disturbances.

MANAGEMENT: Caution is advised when ivabradine is prescribed with CYP450 3A4 inhibitors. Patients should be monitored for adverse effects such as bradycardia and atrial fibrillation, and the dosage of ivabradine adjusted as necessary in accordance with the product labeling.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. (2015) "Product Information. Corlanor (ivabradine)." Amgen USA

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Drug and food interactions

Major

ivabradine food

Applies to: Corlanor (ivabradine)

GENERALLY AVOID: Grapefruit juice may significantly increase the plasma concentrations of ivabradine. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. According to the product labeling, administration with grapefruit juice (quantity unknown) resulted in an approximately twofold increase in ivabradine systemic exposure (AUC). Elevated plasma levels of ivabradine may increase the risk of excessive bradycardia and conduction disturbances.

ADJUST DOSING INTERVAL: Food delays the absorption of ivabradine by approximately 1 hour and increases plasma exposure by 20% to 40% compared to fasting conditions.

MANAGEMENT: Patients treated with ivabradine should avoid or limit consumption of grapefruit or grapefruit juice. The manufacturer recommends taking ivabradine with meals to reduce variability in exposure.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."
  3. (2015) "Product Information. Corlanor (ivabradine)." Amgen USA

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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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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