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Drug Interactions between levamlodipine and Prograf

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

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Interactions between your drugs

Moderate

tacrolimus levamlodipine

Applies to: Prograf (tacrolimus) and levamlodipine

MONITOR: Coadministration with amlodipine may increase the blood concentrations of tacrolimus. The exact mechanism of interaction is unknown but may involve inhibition of the CYP450 3A5 metabolism of tacrolimus. Isolated case reports and one crossover study involving healthy subjects have demonstrated that the AUC of tacrolimus may increase by 2.3-fold or more when taken concomitantly with amlodipine.

MANAGEMENT: Caution is advised if tacrolimus is administered concomitantly with amlodipine. Tacrolimus blood levels should be monitored frequently and the dosage adjusted accordingly, particularly following initiation or discontinuation of amlodipine therapy in patients who are stabilized on their tacrolimus regimen. Patients should be advised to contact their physician if they experience potential signs and symptoms of tacrolimus toxicity such as fever, infection, diarrhea, tremor, headache, fatigue, lethargy, and changes in motor function, mental status, or sensory function.

References

  1. (2002) "Product Information. Norvasc (amlodipine)." Pfizer U.S. Pharmaceuticals
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Cerner Multum, Inc. "Australian Product Information."
  4. Khaira A, Rathi OP, Gupta A, et al. (2009) "Galactorrhoea and mastalgia in a renal transplant recipient on tacrolimus and amlodipine." Nephrology (Carlton), 14, p. 700-1
  5. Zhao W, Baudouin V, Fakhoury M, Storme T, Deschenes G, Jacqz-Aigrain E (2012) "Pharmacokinetic interaction between tacrolimus and amlodipine in a renal transplant child." Transplantation, 93, e29-30
View all 5 references

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Drug and food interactions

Moderate

tacrolimus food

Applies to: Prograf (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

  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

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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.

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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