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Drug Interactions between flucytosine and tacrolimus

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

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Interactions between your drugs

Moderate

flucytosine tacrolimus

Applies to: flucytosine and tacrolimus

MONITOR: Drugs that impair glomerular filtration may prolong the half-life of flucytosine and lead to accumulation. Prolonged flucytosine serum concentrations of greater than 100 mcg/mL may increase the risk of gastrointestinal, hepatic, and hematologic toxicity.

MANAGEMENT: Caution is advised if flucytosine is used in patients who have recently received or are receiving treatment with potentially nephrotoxic drugs (e.g., aminoglycosides; polypeptide, glycopeptide, and polymyxin antibiotics; amphotericin B; adefovir; cidofovir; tenofovir; foscarnet; cisplatin; deferasirox; gallium nitrate; lithium; mesalamine; certain immunosuppressants; intravenous bisphosphonates; intravenous pentamidine; high intravenous dosages of methotrexate; high dosages and/or chronic use of nonsteroidal anti-inflammatory agents). Renal function and flucytosine blood levels should be closely monitored during therapy, and the dose or dosing interval should be adjusted to maintain flucytosine concentrations below 100 mcg/mL.

References (1)
  1. (2002) "Product Information. Ancobon (flucytosine)." Roche Laboratories

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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