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Drug Interactions between cilastatin / imipenem and valganciclovir

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

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Interactions between your drugs

Moderate

imipenem valGANciclovir

Applies to: cilastatin / imipenem and valganciclovir

GENERALLY AVOID: Generalized seizures have occurred in patients concomitantly receiving ganciclovir with products containing imipenem-cilastatin. The mechanism has not been described, but these agents are individually epileptogenic and may have additive effects on seizure threshold during coadministration.

MANAGEMENT: The manufacturers recommend that concomitant use of ganciclovir or its prodrug, valganciclovir, with imipenem-cilastatin be avoided unless the potential benefits outweigh the risks. Patients receiving this combination should be closely monitored for tremors, mental status changes, and seizures.

References (5)
  1. (2002) "Product Information. Cytovene (ganciclovir)." Genentech
  2. (2002) "Product Information. Primaxin (imipenem)." Merck & Co., Inc
  3. (2003) "Product Information. Primaxin (imipenem-cilastatin)." Merck & Co., Inc
  4. (2019) "Product Information. Recarbrio (imipenem/cilastatin/relebactam)." Merck & Co., Inc
  5. (2020) "Product Information. Recarbrio (imipenem/cilastatin/relebactam)." Merck Sharp & Dohme LLC, SUPPL-2

Drug and food interactions

Moderate

valGANciclovir food

Applies to: valganciclovir

ADJUST DOSING INTERVAL: Food increases the bioavailability of ganciclovir from the prodrug, valganciclovir. In 16 HIV-positive subjects, the administration of valganciclovir 875 mg once daily with a high-fat meal containing approximately 600 calories resulted in a 30% increase in the steady-state area under the plasma concentration-time curve (AUC) and a 14% increase in the peak plasma concentration (Cmax) of ganciclovir, with no delay in the time to reach peak plasma concentration (Tmax). The mechanism is unknown.

MANAGEMENT: The manufacturer recommends that valganciclovir be taken with meals.

References (2)
  1. (2001) "Product Information. Valcyte (valganciclovir)." Roche Laboratories
  2. Brown F, Banken L, Saywell K, Arum I (1999) "Pharmacokinetics of valganciclovir and ganciclovir following multiple oral dosages of valganciclovir in HIV- and CMV-seropositiv volunteers." Clin Pharmacokinet, 37, p. 167-76

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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