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Drug Interactions between maribavir and Prograf

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

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Interactions between your drugs

Moderate

tacrolimus maribavir

Applies to: Prograf (tacrolimus) and maribavir

MONITOR: Coadministration of maribavir may increase the plasma concentrations of immunosuppressant drugs that are substrates of CYP450 3A4 and/or P-glycoprotein (P-gp), such as cyclosporine, everolimus, sirolimus, and tacrolimus. The proposed mechanism is decreased clearance of the immunosuppressant drugs due to inhibition of P-gp-mediated drug efflux and CYP450 3A4 by maribavir. In a pharmacokinetic study, tacrolimus peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 38% and 51%, respectively, when maribavir (400 mg twice daily) was concomitantly administered with a stable, twice daily dose of tacrolimus (0.5 to 16 mg total daily dose).

MANAGEMENT: Caution is advised when maribavir is used concurrently with cyclosporine, everolimus, sirolimus, or tacrolimus. Frequent clinical and laboratory monitoring as well as dosage adjustments may be appropriate for the immunosuppressant whenever maribavir is added to or withdrawn from therapy.

References

  1. (2021) "Product Information. Livtencity (maribavir)." Takeda Pharmaceuticals America

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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.

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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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