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Drug Interactions between fidaxomicin and tacrolimus

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

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Interactions between your drugs

Minor

tacrolimus fidaxomicin

Applies to: tacrolimus and fidaxomicin

Coadministration with inhibitors of P-glycoprotein (P-gp) may increase the plasma concentrations of fidaxomicin and its main metabolite, OP-1118, both of which are substrates of the intestinal efflux transporter. When fidaxomicin 200 mg was administered in combination with cyclosporine 200 mg in 14 study subjects, fidaxomicin peak plasma concentration (Cmax) and systemic exposure (AUC) increased by an average of 4.2- and 1.9-fold, respectively, compared to when administered alone. The Cmax and AUC of OP-1118 was increased by 9.5- and 4.1-fold, respectively, with cyclosporine. Theoretically, concentrations of fidaxomicin and OP-1118 may also be decreased at the site of action (i.e., gastrointestinal tract) due to P-gp inhibition. However, concomitant use of a P-gp inhibitor had no attributable effect on safety or efficacy of fidaxomicin in controlled clinical trials. No dosage adjustment is recommended when fidaxomicin is coadministered with P-gp inhibitors.

References (1)
  1. (2011) "Product Information. Dificid (fidaxomicin)." Optimer Pharmaceuticals

Drug and food interactions

Moderate

tacrolimus food

Applies to: tacrolimus

ADJUST DOSING INTERVAL: Consumption of food has led to a 27% decrease in the bioavailability of orally administered tacrolimus.

MANAGEMENT: Tacrolimus should be administered at least one hour before or two hours after meals.

GENERALLY AVOID: Grapefruit juice has been reported to increase tacrolimus trough concentrations. Data are limited, but inhibition of the CYP450 enzyme system appears to be involved.

MANAGEMENT: The clinician may want to recommend that the patient avoid ingesting large amounts of grapefruit juice while taking tacrolimus.

References (2)
  1. (2001) "Product Information. Prograf (tacrolimus)." Fujisawa
  2. Hooks MA (1994) "Tacrolimus, a new immunosuppressant--a review of the literature." Ann Pharmacother, 28, p. 501-11

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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