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Drug Interactions between Cotrim Pediatric and Kuvan

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

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Interactions between your drugs

Moderate

trimethoprim sapropterin

Applies to: Cotrim Pediatric (sulfamethoxazole / trimethoprim) and Kuvan (sapropterin)

MONITOR: Drugs that affect folate metabolism may reduce the efficacy of sapropterin, which is a synthetic form of tetrahydrobiopterin (BH4). Folate antagonists can decrease tetrahydrobiopterin (BH4) levels by inhibiting the enzyme dihydropteridine reductase.

MANAGEMENT: Caution is advised if sapropterin is used in combination with folate antagonists. The potential for diminished pharmacologic effects of sapropterin should be considered.

References

  1. (2007) "Product Information. Kuvan (sapropterin)." BioMarin Pharmaceutical Inc

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Drug and food interactions

Moderate

sapropterin food

Applies to: Kuvan (sapropterin)

ADJUST DOSING INTERVAL: Food increases the gastrointestinal absorption of sapropterin.

MANAGEMENT: Sapropterin should be administered with food, preferably at the same time each day. Sapropterin tablets should be dissolved in 4 to 8 ounces (120 to 240 mL) of water or apple juice and taken within 15 minutes of dissolution.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
  3. (2007) "Product Information. Kuvan (sapropterin)." BioMarin Pharmaceutical Inc
  4. Cerner Multum, Inc. "Australian Product Information."
View all 4 references

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Moderate

sulfamethoxazole food

Applies to: Cotrim Pediatric (sulfamethoxazole / trimethoprim)

MONITOR: Two cases have been reported in which patients on sulfamethoxazole-trimethoprim therapy, after consuming beer, reported flushing, heart palpitations, dyspnea, headache, and nausea (disulfiram - alcohol type reactions). First-generation sulfonylureas have been reported to cause facial flushing when administered with alcohol by inhibiting acetaldehyde dehydrogenase and subsequently causing acetaldehyde accumulation. Since sulfamethoxazole is chemically related to first-generation sulfonylureas, a disulfiram-like reaction with products containing sulfamethoxazole is theoretically possible. However, pharmacokinetic/pharmacodynamic data are lacking and in addition, the two reported cases cannot be clearly attributed to the concomitant use of sulfamethoxazole-trimethoprim and alcohol.

MANAGEMENT: Patients should be alerted to the potential for this interaction and although the risk for this interaction is minimal, caution is recommended while taking sulfamethoxazole-trimethoprim concomitantly with alcohol.

References

  1. Heelon MW, White M (1998) "Disulfiram-cotrimoxazole reaction." Pharmacotherapy, 18, p. 869-70
  2. Mergenhagen KA, Wattengel BA, Skelly MK, Clark CM, Russo TA (2020) "Fact versus fiction: a review of the evidence behind alcohol and antibiotic interactions." Antimicrob Agents Chemother, 64, e02167-19

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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.

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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