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Drug Interactions between levamlodipine and sirolimus

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

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Interactions between your drugs

Moderate

sirolimus levamlodipine

Applies to: sirolimus and levamlodipine

MONITOR: The use of mTOR (mammalian target of rapamycin) inhibitors has been associated with the development of angioedema, and coadministration with amlodipine may increase the risk. The mechanism of this interaction has not been established. The onset of angioedema may sometimes be delayed up to two months following initiation of therapy. In addition, amlodipine, a weak CYP450 3A4 inhibitor, may increase the plasma concentrations of mTOR inhibitors, which are primarily metabolized by the isoenzyme.

MANAGEMENT: Caution is advised if amlodipine is administered with mTOR inhibitors. Clinicians and patients should be aware of the potential for increased plasma levels as well as the risk of angioedema when mTOR inhibitors are prescribed with amlodipine. Dosage adjustments as well as clinical and laboratory monitoring should be considered whenever amlodipine is added to or withdrawn from therapy. Patients should be advised to promptly discontinue these medications and seek medical attention if they develop signs or symptoms suggestive of angioedema such as swelling of the face, extremities, eyes, lips, or tongue, and difficulty swallowing or breathing. Patients should be monitored for development of other adverse effects including hypertension, hyperlipidemia, renal impairment, proteinuria, infections, and various types of malignancies.

References (2)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."

Drug and food interactions

Moderate

sirolimus food

Applies to: sirolimus

ADJUST DOSING INTERVAL: Consumption of food can decrease the rate and extent of gastrointestinal absorption of sirolimus. Also, the consumption of grapefruit juice may result in increased sirolimus trough concentrations.

MANAGEMENT: Experts recommend that this drug be taken either at least one hour prior to eating or consistently with or without food to avoid variations in sirolimus blood levels. The manufacturer recommends against using grapefruit juice for dilution of sirolimus doses. Patients should be monitored for clinical and laboratory evidence of altered immunosuppressant effects.

References (1)
  1. (2001) "Product Information. Rapamune (sirolimus)." Wyeth-Ayerst Laboratories

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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