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Drug Interactions between Grisactin Ultra and Votrient

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

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Interactions between your drugs

Moderate

griseofulvin PAZOPanib

Applies to: Grisactin Ultra (griseofulvin) and Votrient (pazopanib)

GENERALLY AVOID: Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations and pharmacologic effects of pazopanib, which is primarily metabolized by the isoenzyme.

MANAGEMENT: The use of pazopanib in combination with potent CYP450 3A4 inducers such as carbamazepine, dexamethasone, enzalutamide, phenobarbital, phenytoin, rifamycins, and St. John's wort should generally be avoided. Alternative treatment lacking CYP450 3A4-inducing activity should be considered in patients receiving pazopanib; otherwise, pazopanib should not be used. Other known CYP450 3A4 inducers include aminoglutethimide, barbiturates, bexarotene, bosentan, dabrafenib, efavirenz, nafcillin, nevirapine, somatrem, somatropin, and various other anticonvulsants, although the extent to which they may interact with pazopanib is unknown.

References

  1. "Product Information. Votrient (pazopanib)." GlaxoSmithKline (2009):

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Drug and food interactions

Major

PAZOPanib food

Applies to: Votrient (pazopanib)

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of pazopanib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. Although not studied, the interaction may increase the risk of QT interval prolongation and torsade de pointes arrhythmia as well as severe and fatal hepatotoxicity associated with the use of pazopanib.

ADJUST DOSING INTERVAL: Food increases the oral bioavailability of pazopanib. The mechanism of interaction is unknown. Administration of pazopanib with a high-fat or low-fat meal results in an approximately 2-fold increase in peak plasma concentration (Cmax) and systemic exposure (AUC).

MANAGEMENT: Patients treated with pazopanib should avoid consumption of grapefruit, grapefruit juice, and any supplement containing grapefruit extract. Pazopanib should be administered at least one hour before or two hours after a meal.

References

  1. "Product Information. Votrient (pazopanib)." GlaxoSmithKline (2009):

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Moderate

griseofulvin food

Applies to: Grisactin Ultra (griseofulvin)

MONITOR: Isolated case reports have suggested that the ingestion of alcohol during griseofulvin therapy may rarely cause disulfiram-like reactions, flushing, tachycardia, or increased effects of alcohol. The mechanism is unknown.

MANAGEMENT: Patients should be advised of the possibility of increased adverse effects or a disulfiram-like reaction.

References

  1. "Product Information. Grifulvin V (griseofulvin)." Ortho McNeil Pharmaceutical
  2. "Product Information. Fulvicin P/G (griseofulvin)." Schering Corporation PROD (2002):
  3. Cerner Multum, Inc. "Australian Product Information." O 0

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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.


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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.