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Drug Interactions between micafungin and sirolimus

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

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Interactions between your drugs

Moderate

sirolimus micafungin

Applies to: sirolimus and micafungin

MONITOR: Coadministration with micafungin may increase the serum concentrations of sirolimus. The exact mechanism of interaction is unknown but may involve inhibition of sirolimus metabolism, since micafungin has been shown to be a weak inhibitor of CYP450 3A in vitro. According to micafungin product labeling, sirolimus systemic exposure (AUC) was increased by 21% in the presence of micafungin at steady state compared to sirolimus alone. No effect on sirolimus Cmax was observed.

MANAGEMENT: Due to the narrow therapeutic index of sirolimus, pharmacologic response and sirolimus blood levels should be closely monitored following initiation or discontinuation of micafungin therapy in patients who are stabilized on their antirejection regimen, and the sirolimus dosage adjusted accordingly. Patients should be monitored for potential signs and symptoms of sirolimus toxicity such as fever, infection, diarrhea, hypokalemia, anemia, thrombocytopenia, leukopenia, and hyperlipidemia.

References (1)
  1. (2005) "Product Information. Mycamine (micafungin)." Fujisawa

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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