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Can you take Granisol with Saquinavir?

1 drug interaction and 20 additional warnings found for the following 2 drugs:

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Drug interactions

Major drug interactions

Major:

granisetron saquinavir

Applies to: Granisol (granisetron) and saquinavir

Using saquinavir together with granisetron is not recommended. Combining these medications can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect.

You may be more susceptible if you have:

  • a heart condition called congenital long QT syndrome
  • other cardiac diseases
  • conduction abnormalities
  • electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting)

Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact.

You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with either of these medications.

It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

saquinavir Food/Lifestyle

Applies to: saquinavir

Food can enhance the levels of saquinavir in your body. Saquinavir should be taken with meals or within 2 hours after eating. This will make it easier for your body to absorb the medication.

Grapefruit can raise the levels of saquinavir in your body.

Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Disease interactions

19 potential interactions Applies to: 17 conditions, including High Cholesterol, Constipation, Heart Failure, Arrhythmia, and Hypokalemia.

Abnormal Glucose Tolerance

Moderate:

saquinavir

Saquinavir has a moderate potential interaction with Abnormal Glucose Tolerance.

New onset diabetes mellitus, exacerbation of preexisting diabetes mellitus, hyperglycemia, and some cases of diabetic ketoacidosis have been reported during postmarketing surveillance in HIV-infected patients treated with protease inhibitors. Some patients required either initiation or dosage adjustments of insulin or oral hypoglycemic agents for treatment of these events. In some cases, hyperglycemia persisted despite discontinuation of protease inhibitor therapy. A causal relationship has not been established between protease inhibitor therapy and these events. Monitoring patients for hyperglycemia, new onset diabetes mellitus, or exacerbation of diabetes mellitus should be considered during protease inhibitor therapy.

Alcoholism

Moderate:

saquinavir

Saquinavir has a moderate potential interaction with Alcoholism.

Saquinavir is primarily metabolized by the liver. Patients with liver disease may be at greater risk for adverse effects from saquinavir due to decreased drug clearance, so therapy should be administered cautiously in these patients. Additionally, there have been reports of worsening liver disease in patients with underlying hepatitis B or C, cirrhosis, chronic alcoholism, and other liver abnormalities. Close monitoring is recommended. The use of saquinavir when administered with ritonavir is contraindicated in patients with severe hepatic impairment.

Arrhythmia

Major:

saquinavir

Saquinavir has a major potential interaction with Arrhythmia.

QT and PR interval dose-dependent prolongation and torsades de pointes have been reported with the use of saquinavir (saquinavir should always be used in combination with ritonavir). Saquinavir should not be used in patients with congenital long QT syndrome, patients with refractory hypokalemia or hypomagnesemia, or in combination with other drugs that can both prolong the QT interval and increase the plasma concentration of saquinavir. Saquinavir is also contraindicated in patients with a complete atrioventricular (AV) block without an implanted pacemaker or patients at risk of a complete AV block.
Caution and close EKG and electrolyte monitoring is recommended if therapy is initiated in patients with congestive heart failure, bradyarrhythmias, structural heart disease, cardiomyopathies, ischemic heart disease, hepatic impairment, and electrolyte abnormalities.

Moderate:

Granisol

The granisetron in Granisol has a moderate potential interaction with Arrhythmia.

The IV and oral formulations of granisetron should be used with caution in patients with preexisting arrhythmias or cardiac conduction disorders because QT prolongation has been reported. Patients with cardiac disease, electrolyte abnormalities, cardiotoxic chemotherapy, or concomitant QT-prolonging drugs may be particularly at risk for clinical consequences.

Cardiomyopathy

Major:

saquinavir

Saquinavir has a major potential interaction with Cardiomyopathy.

QT and PR interval dose-dependent prolongation and torsades de pointes have been reported with the use of saquinavir (saquinavir should always be used in combination with ritonavir). Saquinavir should not be used in patients with congenital long QT syndrome, patients with refractory hypokalemia or hypomagnesemia, or in combination with other drugs that can both prolong the QT interval and increase the plasma concentration of saquinavir. Saquinavir is also contraindicated in patients with a complete atrioventricular (AV) block without an implanted pacemaker or patients at risk of a complete AV block.
Caution and close EKG and electrolyte monitoring is recommended if therapy is initiated in patients with congestive heart failure, bradyarrhythmias, structural heart disease, cardiomyopathies, ischemic heart disease, hepatic impairment, and electrolyte abnormalities.

Cardiovascular Conditions and Disorders

Moderate:

Granisol

The granisetron in Granisol has a moderate potential interaction with Cardiovascular Conditions and Disorders.

The IV and oral formulations of granisetron should be used with caution in patients with preexisting arrhythmias or cardiac conduction disorders because QT prolongation has been reported. Patients with cardiac disease, electrolyte abnormalities, cardiotoxic chemotherapy, or concomitant QT-prolonging drugs may be particularly at risk for clinical consequences.

Coagulation Defects and Disorders

Moderate:

saquinavir

Saquinavir has a moderate potential interaction with Coagulation Defects and Disorders.

There have been reports of increased bleeding, including spontaneous skin hematomas and hemarthrosis, in patients with hemophilia type A and B treated with protease inhibitors; however, a causal relationship has not been established. In some patients, additional factor VIII was given. In more than half of the reported cases, protease inhibitor therapy was continued or reintroduced. Patients with hemophilia or other coagulation defects should be monitored closely for bleeding during protease inhibitor therapy.

Constipation

Moderate:

Granisol

The granisetron in Granisol has a moderate potential interaction with Constipation.

Granisetron may mask a progressive ileus and/or gastric distention. Monitor for decreased bowel activity, particularly in patients with risk factors for gastrointestinal obstruction or following recent abdominal surgery. In patients with preexisting constipation receiving subcutaneous granisetron, consider optimizing bowel regimens.

Diabetes Mellitus

Moderate:

saquinavir

Saquinavir has a moderate potential interaction with Diabetes Mellitus.

New onset diabetes mellitus, exacerbation of preexisting diabetes mellitus, hyperglycemia, and some cases of diabetic ketoacidosis have been reported during postmarketing surveillance in HIV-infected patients treated with protease inhibitors. Some patients required either initiation or dosage adjustments of insulin or oral hypoglycemic agents for treatment of these events. In some cases, hyperglycemia persisted despite discontinuation of protease inhibitor therapy. A causal relationship has not been established between protease inhibitor therapy and these events. Monitoring patients for hyperglycemia, new onset diabetes mellitus, or exacerbation of diabetes mellitus should be considered during protease inhibitor therapy.

Electrolyte Abnormalities

Moderate:

Granisol

The granisetron in Granisol has a moderate potential interaction with Electrolyte Abnormalities.

The IV and oral formulations of granisetron should be used with caution in patients with preexisting arrhythmias or cardiac conduction disorders because QT prolongation has been reported. Patients with cardiac disease, electrolyte abnormalities, cardiotoxic chemotherapy, or concomitant QT-prolonging drugs may be particularly at risk for clinical consequences.

Gastrointestinal Obstruction

Moderate:

Granisol

The granisetron in Granisol has a moderate potential interaction with Gastrointestinal Obstruction.

Granisetron may mask a progressive ileus and/or gastric distention. Monitor for decreased bowel activity, particularly in patients with risk factors for gastrointestinal obstruction or following recent abdominal surgery. In patients with preexisting constipation receiving subcutaneous granisetron, consider optimizing bowel regimens.

Heart Failure

Major:

saquinavir

Saquinavir has a major potential interaction with Heart Failure.

QT and PR interval dose-dependent prolongation and torsades de pointes have been reported with the use of saquinavir (saquinavir should always be used in combination with ritonavir). Saquinavir should not be used in patients with congenital long QT syndrome, patients with refractory hypokalemia or hypomagnesemia, or in combination with other drugs that can both prolong the QT interval and increase the plasma concentration of saquinavir. Saquinavir is also contraindicated in patients with a complete atrioventricular (AV) block without an implanted pacemaker or patients at risk of a complete AV block.
Caution and close EKG and electrolyte monitoring is recommended if therapy is initiated in patients with congestive heart failure, bradyarrhythmias, structural heart disease, cardiomyopathies, ischemic heart disease, hepatic impairment, and electrolyte abnormalities.

High Cholesterol

Moderate:

saquinavir

Saquinavir has a moderate potential interaction with High Cholesterol.

Treatment with ritonavir alone or in combination with other protease inhibitors (e.g., lopinavir, saquinavir, tipranavir, fosamprenavir) has resulted in substantial increases in the concentration of total cholesterol and triglycerides. These effects have also been reported with other protease inhibitors but may be the most dramatic with ritonavir. The clinical significance of these elevations is unclear. Marked elevation in triglyceride levels is a risk factor for development of pancreatitis. Triglyceride and cholesterol testing is recommended before starting ritonavir (with or without other protease inhibitors) and periodically during therapy. Lipid disorders should be managed as clinically appropriate.

Hypokalemia

Major:

saquinavir

Saquinavir has a major potential interaction with Hypokalemia.

QT and PR interval dose-dependent prolongation and torsades de pointes have been reported with the use of saquinavir (saquinavir should always be used in combination with ritonavir). Saquinavir should not be used in patients with congenital long QT syndrome, patients with refractory hypokalemia or hypomagnesemia, or in combination with other drugs that can both prolong the QT interval and increase the plasma concentration of saquinavir. Saquinavir is also contraindicated in patients with a complete atrioventricular (AV) block without an implanted pacemaker or patients at risk of a complete AV block.
Caution and close EKG and electrolyte monitoring is recommended if therapy is initiated in patients with congestive heart failure, bradyarrhythmias, structural heart disease, cardiomyopathies, ischemic heart disease, hepatic impairment, and electrolyte abnormalities.

Liver Disease

Moderate:

saquinavir

Saquinavir has a moderate potential interaction with Liver Disease.

Saquinavir is primarily metabolized by the liver. Patients with liver disease may be at greater risk for adverse effects from saquinavir due to decreased drug clearance, so therapy should be administered cautiously in these patients. Additionally, there have been reports of worsening liver disease in patients with underlying hepatitis B or C, cirrhosis, chronic alcoholism, and other liver abnormalities. Close monitoring is recommended. The use of saquinavir when administered with ritonavir is contraindicated in patients with severe hepatic impairment.

Magnesium Imbalance

Major:

saquinavir

Saquinavir has a major potential interaction with Magnesium Imbalance.

QT and PR interval dose-dependent prolongation and torsades de pointes have been reported with the use of saquinavir (saquinavir should always be used in combination with ritonavir). Saquinavir should not be used in patients with congenital long QT syndrome, patients with refractory hypokalemia or hypomagnesemia, or in combination with other drugs that can both prolong the QT interval and increase the plasma concentration of saquinavir. Saquinavir is also contraindicated in patients with a complete atrioventricular (AV) block without an implanted pacemaker or patients at risk of a complete AV block.
Caution and close EKG and electrolyte monitoring is recommended if therapy is initiated in patients with congestive heart failure, bradyarrhythmias, structural heart disease, cardiomyopathies, ischemic heart disease, hepatic impairment, and electrolyte abnormalities.

Neutropenia

Moderate:

Granisol

The granisetron in Granisol has a moderate potential interaction with Neutropenia.

Serious or severe injection site reactions have been reported with the subcutaneous formulation of granisetron. Patients who are neutropenic may be at greater risk; monitor for injection site reactions during treatment and consider discontinuing therapy for severe or persistent reactions.

Renal Dysfunction

Moderate:

Granisol

The granisetron in Granisol has a moderate potential interaction with Renal Dysfunction.

The subcutaneous formulation of granisetron should be avoided in patients with severe renal dysfunction. In patients with moderate renal dysfunction, subcutaneous granisetron should not be administered more frequently than once every 14 days because the clinical significance of potential prolonged elimination of the polymer vehicle is unknown.

Moderate:

saquinavir

Saquinavir has a moderate potential interaction with Renal Dysfunction.

The principal route of excretion for saquinavir is by hepatic metabolism, therefore no initial dose adjustment is necessary in patients with renal impairment. However, saquinavir has not been studied in patients with severe renal impairment and end-stage renal disease, and caution should be exercised when prescribing this drug to these patients.

More resources

Granisol

A total of 384 drugs are known to interact with Granisol.

saquinavir

A total of 767 drugs are known to interact with saquinavir.

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.