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Interactions between Intron A and Tacrolimus topical

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

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Drug interactions

Moderate drug interactions

Moderate:

interferon alfa-2b tacrolimus topical

Applies to: Intron A (interferon alfa-2b) and tacrolimus topical
Generally avoid

Coadministration of topical tacrolimus with other immunosuppressive agents may potentiate the immunosuppressive effects of topical tacrolimus. However, data concerning its safety and efficacy in combination with immunosuppressants are not available. According to the prescribing information, rare cases of skin malignancy and lymphoma have been reported in patients who have received treatment with topical calcineurin inhibitors, including topical tacrolimus. On the other hand, systemic exposure from topical tacrolimus is reported to be less than 1 ng/mL. In addition, the lowest tacrolimus blood concentration from topical application at which systemic effects can be observed is unknown.

Management

According to the manufacturer, use of topical tacrolimus in immunocompromised patients is not recommended. Therefore, until further information is available, it may be advisable to avoid its concomitant use with other immunosuppressants. Screening for the development of malignancy during and after treatment may also be considered.

References (3)
  1. (2024) "Product Information. Tacrolimus Topical (tacrolimus topical)." Accord-UK Ltd
  2. (2023) "Product Information. Protopic (tacrolimus topical)." Leo Pharma Inc
  3. (2023) "Product Information. Azematop (TACrolimus topical)." Accord Healthcare Pty Ltd

Food/lifestyle interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Disease interactions

20 potential interactions Applies to: 19 conditions, including Depression, Underactive Thyroid, Heart Failure, Seizures, and Peripheral Neuropathy.

Arrhythmia

Major:

Intron A

The interferon alfa-2b in Intron A has a major potential interaction with Arrhythmia.

Hypertension, arrhythmias, angina, myocardial infarction, cardiomyopathy, and congestive heart failure have been reported during interferon therapy. Therapy with interferons should be administered with caution in patients with compromised cardiac function.

Autoimmune Disorders

Major:

Intron A

The interferon alfa-2b in Intron A has a major potential interaction with Autoimmune Disorders.

Antiviral interferons may exacerbate autoimmune disorders such as myositis, thyroiditis, systemic lupus erythematosus, rheumatoid arthritis, psoriasis, or autoimmune hepatitis. Therapy should be avoided or administered with extreme caution in patients with autoimmune disorders.

Bone Marrow Depression/Low Blood Counts

Moderate:

Intron A

The interferon alfa-2b in Intron A has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.

Interferons (alfa and gamma) induce a dose-dependent, generally mild, myelosuppression. Leukopenia is the primary manifestation. Thrombocytopenia and anemia occur less frequently. Therapy with interferons (alfa and gamma) should be administered cautiously to patients with bone marrow suppression. Clinical monitoring of hematopoietic function is recommended.

Cardiovascular Conditions and Disorders

Major:

Intron A

The interferon alfa-2b in Intron A has a major potential interaction with Cardiovascular Conditions and Disorders.

Hypertension, arrhythmias, angina, myocardial infarction, cardiomyopathy, and congestive heart failure have been reported during interferon therapy. Therapy with interferons should be administered with caution in patients with compromised cardiac function.

Depression

Major:

Intron A

The interferon alfa-2b in Intron A has a major potential interaction with Depression.

Interferons (alfa or beta) can induce depression and suicidal behavior. Suicidal attempts and suicides have been reported. Therapy with interferons (alfa or beta) should be administered cautiously to patients with or predisposed to mental depression. Clinical monitoring of psychological status is recommended.

Diabetes Mellitus

Moderate:

Intron A

The interferon alfa-2b in Intron A has a moderate potential interaction with Diabetes Mellitus.

Flu-like symptoms frequently associated with interferon-alfa therapy can precipitate ketoacidosis in diabetic patients. Therapy with interferon alfa should be administered cautiously in patients with diabetes mellitus. Clinical monitoring of blood glucose concentrations and anti-diabetic therapy is recommended.

Heart Failure

Major:

Intron A

The interferon alfa-2b in Intron A has a major potential interaction with Heart Failure.

Hypertension, arrhythmias, angina, myocardial infarction, cardiomyopathy, and congestive heart failure have been reported during interferon therapy. Therapy with interferons should be administered with caution in patients with compromised cardiac function.

Hyperthyroidism

Major:

Intron A

The interferon alfa-2b in Intron A has a major potential interaction with Hyperthyroidism.

Thyroid abnormalities, hypothyroidism or hyperthyroidism, have been reported in patients administered interferons. Therapy with interferons should be administered cautiously to patients with thyroid dysfunction. If thyroid control cannot be maintained within normal limits with medication, interferon-alfa should be discontinued. Clinical monitoring of thyroid function is recommended.

Immunodeficiency

Major:

tacrolimus topical

Tacrolimus topical has a major potential interaction with Immunodeficiency.

The use of calcineurin inhibitors as pimecrolimus and tacrolimus topical should be avoided in immunocompromised adults and children, including patients on systemic immunosuppressive medications. Although causal relationship has not been established, there is a concern about a potential risk of infections, lymphomas and skin malignancies when using topical calcineurin inhibitors for a prolonged time.

Ischemic Heart Disease

Major:

Intron A

The interferon alfa-2b in Intron A has a major potential interaction with Ischemic Heart Disease.

Hypertension, arrhythmias, angina, myocardial infarction, cardiomyopathy, and congestive heart failure have been reported during interferon therapy. Therapy with interferons should be administered with caution in patients with compromised cardiac function.

Liver Disease

Major:

Intron A

The interferon alfa-2b in Intron A has a major potential interaction with Liver Disease.

Hepatotoxicity, including fatal cases, has been reported in patients treated with interferon alpha. Additionally, the risk of hepatic decompensation and death is increased in patients with cirrhosis. Any patient developing liver function abnormalities during treatment should be monitored closely and treatment should be discontinued if appropriate. Interferon-alfa is contraindicated in patients with autoimmune hepatitis and decompensated liver disease.

Parkinsonism

Major:

Intron A

The interferon alfa-2b in Intron A has a major potential interaction with Parkinsonism.

Reversible CNS effects such as seizures, mental status changes, manic behavior or psychotic reactions, gait disturbances, and dizziness have occurred in patients receiving interferons. Therapy with interferons should be administered cautiously in patients with or predisposed to seizures, psychiatric disorders, or conditions affecting posture or gait.

Peripheral Neuropathy

Moderate:

Intron A

The interferon alfa-2b in Intron A has a moderate potential interaction with Peripheral Neuropathy.

Paresthesia and numbness have been reported during interferon therapy. Therapy with interferons should be administered cautiously in patients with or predisposed to peripheral neuropathy.

Psychosis

Major:

Intron A

The interferon alfa-2b in Intron A has a major potential interaction with Psychosis.

Reversible CNS effects such as seizures, mental status changes, manic behavior or psychotic reactions, gait disturbances, and dizziness have occurred in patients receiving interferons. Therapy with interferons should be administered cautiously in patients with or predisposed to seizures, psychiatric disorders, or conditions affecting posture or gait.

Renal Dysfunction

Major:

Intron A

The interferon alfa-2b in Intron A has a major potential interaction with Renal Dysfunction.

Proteinuria (rare), not associated with a decrease in serum protein, is the most common renal toxicity observed with interferon- alfa therapy. Increased BUN and serum creatinine levels, hematuria, acute renal failure and nephrotic syndrome have also been reported. Therapy with interferon alfa should be administered cautiously to patients with severe renal dysfunction. Renal function should be evaluated in all patients before initiation of interferon- alfa therapy. In addition, patients with any degree of renal impairment should be carefully monitored for laboratory abnormalities and decreased creatinine clearance. A reduced dose of medication is recommended in patients with low CrCl (less than 50 mL/min - 30 mL/min).

Moderate:

tacrolimus topical

Tacrolimus topical has a moderate potential interaction with Renal Dysfunction.

Rare postmarketing cases of acute renal failure have been reported in patients treated with topical tacrolimus. Systemic absorption is most likely to occur in patients with epidermal barrier defects, and when topical tacrolimus is applied to large body surface areas. Caution should be exercised in patients with history of renal impairment or predisposed to renal impairment.

Seizures

Major:

Intron A

The interferon alfa-2b in Intron A has a major potential interaction with Seizures.

Reversible CNS effects such as seizures, mental status changes, manic behavior or psychotic reactions, gait disturbances, and dizziness have occurred in patients receiving interferons. Therapy with interferons should be administered cautiously in patients with or predisposed to seizures, psychiatric disorders, or conditions affecting posture or gait.

Skin Cancer

Moderate:

tacrolimus topical

Tacrolimus topical has a moderate potential interaction with Skin Cancer.

The use of calcineurin inhibitors such as pimecrolimus and tacrolimus topical should be avoided on malignant or premalignant skin conditions. Some of these conditions might present as dermatitis. Calcineurin inhibitors should also be avoided in any skin conditions where there is the potential for increased systemic absorption of the medication as when there is a skin barrier defect.

Ulcerative Colitis

Moderate:

Intron A

The interferon alfa-2b in Intron A has a moderate potential interaction with Ulcerative Colitis.

Fatal and nonfatal ulcerative or hemorrhagic/ischemic colitis have been observed within 12 weeks of the start of alpha interferon treatment. Abdominal pain, bloody diarrhea, and fever are the typical manifestations. Treatment should be discontinued immediately in patients who develop these signs and symptoms. The colitis usually resolves within 1 to 3 weeks of discontinuation of alpha interferons.

Underactive Thyroid

Major:

Intron A

The interferon alfa-2b in Intron A has a major potential interaction with Underactive Thyroid.

Thyroid abnormalities, hypothyroidism or hyperthyroidism, have been reported in patients administered interferons. Therapy with interferons should be administered cautiously to patients with thyroid dysfunction. If thyroid control cannot be maintained within normal limits with medication, interferon-alfa should be discontinued. Clinical monitoring of thyroid function is recommended.

More resources

Intron A

A total of 272 drugs are known to interact with Intron A.

tacrolimus topical

A total of 409 drugs are known to interact with tacrolimus topical.

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.