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Drug interactions between everolimus and temsirolimus

Results for the following 2 drugs:
everolimus
temsirolimus

Interactions between your drugs

Major

everolimus ↔ temsirolimus

Applies to:everolimus and temsirolimus

Consumer information for this interaction is not currently available.

MONITOR CLOSELY: Coadministration of macrolide immunosuppressants with other nephrotoxic agents may increase the risk and severity of renal impairment due to additive effects on the kidney. No formal interaction studies have been performed. However, clinical experience in coadministration with cyclosporine indicates increased renal toxicity as evidenced by increased serum creatinine and decreased glomerular filtration rate. An interaction with ibuprofen resulting in acute renal failure was suspected in two liver transplant patients who had been stabilized on tacrolimus.

MANAGEMENT: Caution is advised if macrolide immunosuppressants must be used in patients who have recently received or are receiving treatment with other potentially nephrotoxic drugs (e.g., aminoglycosides; polypeptide, glycopeptide, and polymyxin antibiotics; amphotericin B; adefovir; cidofovir; tenofovir; foscarnet; cisplatin; cyclosporine; deferasirox; gallium nitrate; lithium; mesalamine; intravenous bisphosphonates; intravenous pentamidine; high intravenous dosages of methotrexate; high dosages and/or chronic use of nonsteroidal anti-inflammatory agents). Renal function should be closely monitored both during and after discontinuation of therapy. Patients should be advised to seek medical attention if they experience symptoms that may indicate nephrotoxicity such as decreased urine output, sudden weight gain, fluid retention, edema, or shortness of breath.

References

  1. "Product Information. Prograf (tacrolimus)." Fujisawa, Deerfield, IL.
  2. "Product Information. Rapamune (sirolimus)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. Sheiner PA, Mor E, Chodoff L, Glabman S, Emre S, Schwartz ME, Miller CM "Acute renal, failure associated with the use of ibuprofen in two liver transplant recipients on FK506." Transplantation 57 (1994): 1132-3

Drug and food interactions

Moderate

everolimus food

Applies to: everolimus

Grapefruit juice can increase the blood levels and effects of everolimus. You should not drink grapefruit juice or eat grapefruits during your treatment with everolimus. Orange juice is not expected to interact.

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Moderate

temsirolimus food

Applies to: temsirolimus

If you are receiving therapy with temsirolimus you should avoid grapefruits and grapefruit juice. Grapefruit can raise the levels of temsirolimus in your body and lead to dangerous side effects. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

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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

Macrolide immunosuppressants

Therapeutic duplication

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

  • everolimus
  • temsirolimus

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

Duplication

MTOR inhibitors

Therapeutic duplication

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

  • everolimus
  • temsirolimus

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

Drug Interaction Classification

The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
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 information available.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2018 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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