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Drug Interactions between leflunomide and torsemide

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

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Interactions between your drugs

Moderate

torsemide leflunomide

Applies to: torsemide and leflunomide

MONITOR: Coadministration with inhibitors of CYP450 2C9 may increase the plasma concentrations of torsemide. The interaction has not been evaluated in pharmacokinetic studies; however, torsemide has been shown to undergo metabolism by CYP450 2C9.

MANAGEMENT: Caution is advised when torsemide is prescribed with CYP450 2C9 inhibitors. Patients should be monitored for potentially increased adverse effects such as dehydration, hypotension, electrolyte imbalances, hyperglycemia, tinnitus, and hearing loss.

References (4)
  1. "Product Information. Demadex (torsemide)." Boehringer Mannheim
  2. Miners JO, Rees DLP, Valente L, Veronese ME, Birkett DJ (1995) "Human hepatic cytochrome p450 2c9 catalyzes the rate-limiting pathway of torsemide metabolism." J Pharmacol Exp Ther, 272, p. 1076-81
  3. Miners JO, Birkett DJ (1998) "Cytochrome P4502C9: an enzyme of major importance in human drug metabolism." Br J Clin Pharmacol, 45, p. 525-38
  4. Vormfelde SV, Engelhardt S, Zirk A, et al. (2004) "CYP2C9 polymorphisms and the interindividual variability in pharmacokinetics and pharmacodynamics of the loop diuretic drug torsemide." Clin Pharmacol Ther, 76, p. 557-66

Drug and food interactions

Moderate

leflunomide food

Applies to: leflunomide

GENERALLY AVOID: The consumption of alcohol during therapy with leflunomide may potentiate the risk of liver injury. Leflunomide has been associated with hepatotoxicity, including elevated liver transaminases, hepatitis, jaundice/cholestasis, hepatic failure, and acute hepatic necrosis,

MANAGEMENT: Patients should be advised to avoid excessive alcohol use during leflunomide treatment.

References (3)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
  3. Cerner Multum, Inc. "Australian Product Information."

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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