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Drug Interactions between methoxyflurane and Privigen

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

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Interactions between your drugs

Major

methoxyflurane immune globulin intravenous

Applies to: methoxyflurane and Privigen (immune globulin intravenous)

MONITOR CLOSELY: Coadministration of intravenous immune globulin preparations with nephrotoxic agents may potentiate the risk of renal impairment. Many commercially available intravenous formulations of immune globulin contain sucrose as a stabilizer. Immune globulin products, particularly those that contain sucrose as a stabilizer and administered at daily doses of 350 to 400 mg/kg or greater, have been associated with renal dysfunction, acute renal failure, osmotic nephrosis, and death. Factors predisposing to acute renal failure include any degree of preexisting renal insufficiency, age greater than 65 years, diabetes mellitus, volume depletion, sepsis, paraproteinemia, and concomitant use of known nephrotoxic drugs.

MANAGEMENT: Intravenous immune globulin preparations should be administered cautiously in patients treated with other potentially nephrotoxic agents (e.g., e.g., aminoglycosides; polypeptide, glycopeptide, and polymyxin antibiotics; amphotericin B; adefovir; cidofovir; tenofovir; foscarnet; cisplatin; deferasirox; gallium nitrate; lithium; mesalamine; certain immunosuppressants; intravenous bisphosphonates; intravenous pentamidine; high intravenous dosages of methotrexate; high dosages and/or chronic use of nonsteroidal anti-inflammatory agents). The manufacturers recommend administering immune globulin infusions at the minimum concentration available and at the minimum rate of infusion feasible in such patients. Clinicians should ensure that patients are not volume depleted prior to the initiation of immune globulin therapy. Monitoring of urine output and renal function tests, including the measurement of blood urea nitrogen (BUN) and serum creatinine, is recommended prior to the initial infusion and at appropriate intervals thereafter. If renal function deteriorates, discontinuation of the product should be considered. Patients should be advised to seek medical attention if they experience symptoms that may indicate nephrotoxicity such as decreased urine output, sudden weight gain, fluid retention, edema, or shortness of breath.

References

  1. "Product Information. Cytogam (cytomegalovirus immune globulin)." CSL Behring LLC (2002):
  2. "Product Information. Respigam (respiratory syncytial virus immune globulin)." Medimmune Inc (2005):
  3. "Product Information. BabyBIG (botulism immune globulin)." FFF Enterprises (2008):
  4. "Product Information. Bivigam (immune globulin intravenous)." Biotest Pharmaceuticals Corporation (2013):
  5. MMWR Morb Mortal Wkly Rep "Renal insufficiency and failure associated with immune globulin intravenous therapy -- United States, 1985-1998. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4824a3.htm" (2013):
  6. Pusey EY, Levy JB "Nephrotoxicity of intravenous immunoglobulin. http://qjmed.oxfordjournals.org/content/93/11/751.full.pdf+html" (2013):
  7. KDIGO. Kidney Disease Improving Global Outcomes "KDIGO clinical practice guideline for acute kidney injury. http://www.kdigo.org/clinical_practice_guidelines/pdf/KDIGO-AKI-Suppl-Appendices-A-F_March2012.pdf" (2013):
  8. Guo X, Nzerue C "How to prevent, recognize, and treat drug-induced nephrotoxicity. http://www.ccjm.org/content/69/4/289.full.pdf" (2013):
  9. Perazella MA "Renal vulnerability to drug toxicity. http://www.ccjm.org/content/69/4/289.full.pdf" (2013):
  10. Naughton CA "Drug-induced nephrotoxicity. http://www.aafp.org/afp/2008/0915/p743.html" (2013):
  11. Moses S "Nephrotoxic drugs, drug-induced nephrotoxicity. http://www.fpnotebook.com/Renal/Pharm/NphrtxcDrgs.htm" (2013):
View all 11 references

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Drug and food interactions

Moderate

methoxyflurane food

Applies to: methoxyflurane

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of central nervous system (CNS)-active agents. Use in combination may result in additive CNS depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled against driving, operating machinery, or engaging in potentially hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  4. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  5. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
View all 5 references

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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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