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Drug Interactions between deflazacort and Exjade

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

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Interactions between your drugs

Major

deflazacort deferasirox

Applies to: deflazacort and Exjade (deferasirox)

MONITOR CLOSELY: Coadministration with drugs that have known ulcerogenic or hemorrhagic potential may increase the risk of gastrointestinal bleeding associated with the use of deferasirox. Fatal gastrointestinal hemorrhages have been reported during deferasirox therapy, especially in elderly patients with advanced hematologic malignancies and/or low platelet counts. Nonfatal upper gastrointestinal irritation, ulceration, and hemorrhage have also been reported, including in children and adolescents.

MANAGEMENT: Caution is advised if deferasirox is prescribed with drugs that have known ulcerogenic or hemorrhagic potential, including but not limited to NSAIDs, salicylates, corticosteroids, oral bisphosphonates, platelet inhibitors, anticoagulants, thrombolytic agents, or agents that commonly cause thrombocytopenia. Patients should be advised to contact their physician if they develop potential signs and symptoms of gastrointestinal injury such as abdominal pain, bloating, dizziness, lightheadedness, hematemesis, anorexia, and/or black, tarry stools.

References (1)
  1. (2005) "Product Information. Exjade (deferasirox)." Novartis Pharmaceuticals

Drug and food interactions

Moderate

deflazacort food

Applies to: deflazacort

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of 21-desdeflazacort, the active metabolite of deflazacort that is formed by esterases after oral administration and further metabolized by CYP450 3A4 to several inactive metabolites. The proposed mechanism is inhibition of CYP450 3A4-mediated metabolism in the gut wall by certain compounds present in grapefruit. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition. Increased systemic exposure to 21-desdeflazacort may increase the risk of corticosteroid adverse effects such as hypercorticism, hyperglycemia, adrenal suppression, immunosuppression, hypertension, salt and water retention, electrolyte abnormalities, behavioral and mood disturbances, posterior subcapsular cataracts, glaucoma, bone loss, and growth retardation in children and adolescents.

MANAGEMENT: Deflazacort should not be administered with grapefruit juice.

References (1)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
Moderate

deferasirox food

Applies to: Exjade (deferasirox)

ADJUST DOSING INTERVAL: According to product labeling, the bioavailability of deferasirox was variably increased when taken with a meal.

MANAGEMENT: To ensure consistent plasma drug levels, deferasirox should be taken on an empty stomach 30 minutes before eating preferably at the same time everyday.

References (1)
  1. (2005) "Product Information. Exjade (deferasirox)." Novartis Pharmaceuticals

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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