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Drug Interactions between Lipitor and satralizumab

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

  • Lipitor (atorvastatin)
  • satralizumab

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Interactions between your drugs

Moderate

atorvastatin satralizumab

Applies to: Lipitor (atorvastatin) and satralizumab

Consumer information for this interaction is not currently available.

MONITOR: Plasma concentrations of drugs that are CYP450 substrates may decrease following the initiation of interleukin (IL) inhibitors, tumor necrosis factor (TNF) blockers, or interferon (IFN) inhibitors in patients with chronic inflammatory diseases. Because the formation of hepatic CYP450 enzymes is down-regulated during infection and chronic inflammation by increased levels of certain cytokines (e.g., interleukins-1, -6, and -10; tumor necrosis factor alpha; interferons), treatment targeting these cytokines may restore or normalize CYP450 enzyme levels resulting in increased metabolism of these drugs. In vitro studies showed that tocilizumab, an IL-6 inhibitor, has the potential to impact expression of various hepatic microsomal enzymes including CYP450 1A2, 2B6, 2C9, 2C19, 2D6, and 3A4. Its effects on CYP450 2C8 or transporters is unknown. In vivo studies with omeprazole (a substrate of CYP450 2C19 and 3A4) and simvastatin (a substrate of CYP450 3A4 and OATP 1B1) showed decreases of up to 28% and 57% in systemic exposure, respectively, one week following a single dose of tocilizumab. Likewise, simvastatin and simvastatin acid exposures decreased by 45% and 36%, respectively, in 17 patients with rheumatoid arthritis one week following a single 200 mg subcutaneous dose of sarilumab, another IL-6 inhibitor. A role for other interleukins such as IL-12, IL-17A, or IL-23 in the regulation of CYP450 enzymes has not been established, and it is not known whether antagonists of these interleukins would similarly affect CYP450 metabolism. Risankizumab and tildrakizumab, both IL-23 antagonists, demonstrated no clinically significant effects when tested with CYP450 probe substrates such as caffeine (1A2), warfarin (2C9), omeprazole (2C19), dextromethorphan (2D6), metoprolol (2D6), and midazolam (3A4) in study subjects with plaque psoriasis.

MANAGEMENT: Caution is advised when treatments targeting cytokines such as interleukins, tumor necrosis factors, or interferons are prescribed to patients receiving concomitant drugs that are CYP450 substrates, particularly those with narrow therapeutic ranges (e.g., antiarrhythmics, anticonvulsants, immunosuppressants, theophylline) or sensitive substrates where decreases in plasma levels may be significant or undesirable (e.g., oral contraceptives, statins, benzodiazepines, opioids). Clinical and/or laboratory monitoring should be considered following the initiation or withdrawal of such treatments, and the dosage(s) of the CYP450 substrate(s) adjusted accordingly. Clinicians should note that the effects of IL inhibitors, TNF blockers, and IFN inhibitors on CYP450 activities may persist for several weeks after stopping therapy.

References

  1. "Product Information. Skyrizi (risankizumab)." AbbVie US LLC, North Chicago, IL.
  2. "Product Information. Ilaris (canakinumab)." Novartis Pharmaceuticals, East Hanover, NJ.
  3. "Product Information. Gamifant (emapalumab)." Sobi Inc, Ardmore, PA.
  4. "Product Information. Cosentyx (secukinumab)." Novartis Pharmaceuticals, East Hanover, NJ.
  5. "Product Information. Kevzara (sarilumab)." sanofi-aventis, Bridgewater, NJ.
  6. "Product Information. Simponi (golimumab)." Centocor Inc, Malvern, PA.
  7. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  8. "Product Information. Sylvant (siltuximab)." Janssen Biotech, Inc., Horsham, PA, PA.
  9. "Product Information. Stelara (ustekinumab)." Centocor Inc, Malvern, PA.
  10. "Product Information. Ilumya (tildrakizumab)." Merck & Company Inc, Whitehouse Station, NJ.
  11. "Product Information. Actemra (tocilizumab)." Genentech, South San Francisco, CA.
  12. "Product Information. Amevive (alefacept)." Biogen, Cambridge, MA.
  13. "Product Information. Remicade (infliximab)." Centocor Inc, Malvern, PA.
  14. "Product Information. Taltz Autoinjector (ixekizumab)." Eli Lilly and Company, Indianapolis, IN.
  15. "Product Information. Arcalyst (rilonacept)." Regeneron Pharmaceuticals Inc, Tarrytown, NY.
View all 15 references

Drug and food interactions

Moderate

atorvastatin food

Applies to: Lipitor (atorvastatin)

Grapefruit juice can increase the blood levels of atorvastatin. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. You should limit your consumption of grapefruit juice to no more than 1 quart per day during treatment with atorvastatin. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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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.

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.