Can you take Mono-Gesic with Voclosporin?
1 drug interaction and 34 additional warnings found for the following 2 drugs:
- Mono-Gesic (salsalate)
- voclosporin
Drug interactions
Moderate drug interactions
Moderate:
salsalate voclosporin
Applies to: Mono-Gesic (salsalate) and voclosporin
Voclosporin may cause kidney problems and combining it with other medications that can also affect the kidney such as salsalate may increase that risk. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek immediate medical attention if you develop signs and symptoms that may suggest kidney damage such as nausea, vomiting, loss of appetite, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, shortness of breath, bone pain, muscle cramps, tiredness, weakness, dizziness, confusion, and irregular heart rhythm. 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.
Food/lifestyle interactions
Major food/lifestyle interactions
Major:
voclosporin Food/Lifestyle
Applies to: voclosporin
Food may delay and reduce the absorption of voclosporin, which may lead to lower blood levels of the medication and possibly reduced effectiveness. Voclosporin should be taken on an empty stomach at least 1 hour before or 2 hours after food. This will make it easier for your body to absorb the medication. Also, while taking voclosporin, you should avoid grapefruits and grapefruit juice. Grapefruit can raise the blood levels of voclosporin in your body and lead to increased adverse effects. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. Also, if you are taking voclosporin you should avoid potassium-containing salt substitutes or over-the-counter potassium supplements without first talking to your doctor. Taking voclosporin together with these salt substitutes or supplements may cause high levels of potassium in your blood. High levels of potassium can cause weakness, irregular heartbeat, confusion, tingling of the extremities, or feelings of heaviness in the legs. Call your doctor at once if you have any of these symptoms. 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.
Moderate food/lifestyle interactions
Moderate:
salsalate Alcohol (Ethanol)
Applies to: Mono-Gesic (salsalate)
Ask your doctor before using salsalate together with ethanol (alcohol). Do not drink alcohol while taking salsalate. Alcohol can increase your risk of stomach bleeding caused by salsalate. Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds. 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.
Disease interactions
32 potential interactions Applies to: 29 conditions, including High Blood Pressure, Seizures, Gastritis/Duodenitis, Arrhythmia, and Anemia.
Alcoholism
Major:
Mono-Gesic
The salsalate in Mono-Gesic has a major potential interaction with Alcoholism.
Salicylates, particularly aspirin, can cause dose-related gastrointestinal bleeding and mucosal damage, which may occur independently of each other. Occult, often asymptomatic GI blood loss is quite common with usual dosages of aspirin and stems from the drug's local effect on the GI mucosa. During chronic therapy, this type of bleeding may occasionally produce iron deficiency anemia. In contrast, major upper GI bleeding rarely occurs except in patients with active peptic ulcers or recent GI bleeding. However, these patients generally do not experience greater occult blood loss than healthy patients following small doses of aspirin. Mucosal damage associated with the use of salicylates may lead to development of peptic ulcers with or without bleeding, reactivation of latent ulcers, and ulcer perforation. Therapy with salicylates and related agents such as salicylamide should be considered and administered cautiously in patients with a history of GI disease or alcoholism, particularly if they are elderly and/or debilitated, since such patients may be more susceptible to the GI toxicity of these drugs and seem to tolerate ulceration and bleeding less well than other individuals. Extreme caution and thorough assessment of risks and benefits are warranted in patients with active or recent GI bleeding or lesions. Whenever possible, especially if prolonged use is anticipated, treatment with non-ulcerogenic agents should be attempted first. If salicylates are used, close monitoring for toxicity is recommended. Some adverse GI effects may be minimized by administration with high dosages of antacids, use of enteric-coated or extended-release formulations, and/or concurrent use of a histamine H2-receptor antagonist or a cytoprotective agent such as misoprostol. Patients with active peptic ulceration or GI bleeding treated with salicylates should generally be administered a concomitant anti-ulcer regimen.
Anemia
Moderate:
Mono-Gesic
The salsalate in Mono-Gesic has a moderate potential interaction with Anemia.
Occult, often asymptomatic GI blood loss occurs quite frequently with the use of normal dosages of aspirin and stems from the drug's local effect on the GI mucosa. During chronic therapy, this type of bleeding may occasionally produce iron deficiency anemia. Other salicylates reportedly cause little or no GI blood loss at usual dosages, but may do so at high dosages. Prolonged therapy with salicylates, particularly aspirin, should be administered cautiously in patients with or predisposed to anemia. Periodic monitoring of hematocrit is recommended. The same precautions should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.
Arrhythmia
Moderate:
voclosporin
Voclosporin has a moderate potential interaction with Arrhythmia.
The use of voclosporin prolongs the QTc interval in a dose-dependent manner. Studies have demonstrated that after a single dose administration at a dose higher than the recommended lupus nephritis therapeutic dose, dose-dependent QT prolongation effect was observed. Care is recommended when using this drug in patients at risk, such as patients taking concomitant drugs known to prolong the QTc interval, patients with bradycardia, hypokalemia, or hypomagnesemia, and the presence of congenital prolongation of the QT interval. Consider obtaining electrocardiograms and monitoring electrolytes in patients at high risk.
Bleeding Disorder
Moderate:
Mono-Gesic
The salsalate in Mono-Gesic has a moderate potential interaction with Bleeding Disorder.
All salicylates can interfere with the action of vitamin K and induce a dose-dependent alteration in hepatic synthesis of coagulation factors VII, IX and X. At usual recommended dosages, a slight increase in prothrombin time (PT) may occur. Therapy with salicylates, especially if given in high dosages, should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. The same precaution should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.
Coagulation Defects and Disorders
Moderate:
Mono-Gesic
The salsalate in Mono-Gesic has a moderate potential interaction with Coagulation Defects and Disorders.
All salicylates can interfere with the action of vitamin K and induce a dose-dependent alteration in hepatic synthesis of coagulation factors VII, IX and X. At usual recommended dosages, a slight increase in prothrombin time (PT) may occur. Therapy with salicylates, especially if given in high dosages, should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. The same precaution should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.
Colonic Ulceration
Major:
Mono-Gesic
The salsalate in Mono-Gesic has a major potential interaction with Colonic Ulceration.
Salicylates, particularly aspirin, can cause dose-related gastrointestinal bleeding and mucosal damage, which may occur independently of each other. Occult, often asymptomatic GI blood loss is quite common with usual dosages of aspirin and stems from the drug's local effect on the GI mucosa. During chronic therapy, this type of bleeding may occasionally produce iron deficiency anemia. In contrast, major upper GI bleeding rarely occurs except in patients with active peptic ulcers or recent GI bleeding. However, these patients generally do not experience greater occult blood loss than healthy patients following small doses of aspirin. Mucosal damage associated with the use of salicylates may lead to development of peptic ulcers with or without bleeding, reactivation of latent ulcers, and ulcer perforation. Therapy with salicylates and related agents such as salicylamide should be considered and administered cautiously in patients with a history of GI disease or alcoholism, particularly if they are elderly and/or debilitated, since such patients may be more susceptible to the GI toxicity of these drugs and seem to tolerate ulceration and bleeding less well than other individuals. Extreme caution and thorough assessment of risks and benefits are warranted in patients with active or recent GI bleeding or lesions. Whenever possible, especially if prolonged use is anticipated, treatment with non-ulcerogenic agents should be attempted first. If salicylates are used, close monitoring for toxicity is recommended. Some adverse GI effects may be minimized by administration with high dosages of antacids, use of enteric-coated or extended-release formulations, and/or concurrent use of a histamine H2-receptor antagonist or a cytoprotective agent such as misoprostol. Patients with active peptic ulceration or GI bleeding treated with salicylates should generally be administered a concomitant anti-ulcer regimen.
G-6-PD Deficiency
Moderate:
Mono-Gesic
The salsalate in Mono-Gesic has a moderate potential interaction with G-6-PD Deficiency.
Salicylates, particularly aspirin, may cause or aggravate hemolysis in patients with pyruvate kinase or glucose-6-phosphate dehydrogenase (G-6-PD) deficiency. However, this effect has not been clearly established. Until more data are available, therapy with salicylates should be administered cautiously in patients with G-6-PD deficiency. The same precaution should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.
Gastritis/Duodenitis
Major:
Mono-Gesic
The salsalate in Mono-Gesic has a major potential interaction with Gastritis/Duodenitis.
Salicylates, particularly aspirin, can cause dose-related gastrointestinal bleeding and mucosal damage, which may occur independently of each other. Occult, often asymptomatic GI blood loss is quite common with usual dosages of aspirin and stems from the drug's local effect on the GI mucosa. During chronic therapy, this type of bleeding may occasionally produce iron deficiency anemia. In contrast, major upper GI bleeding rarely occurs except in patients with active peptic ulcers or recent GI bleeding. However, these patients generally do not experience greater occult blood loss than healthy patients following small doses of aspirin. Mucosal damage associated with the use of salicylates may lead to development of peptic ulcers with or without bleeding, reactivation of latent ulcers, and ulcer perforation. Therapy with salicylates and related agents such as salicylamide should be considered and administered cautiously in patients with a history of GI disease or alcoholism, particularly if they are elderly and/or debilitated, since such patients may be more susceptible to the GI toxicity of these drugs and seem to tolerate ulceration and bleeding less well than other individuals. Extreme caution and thorough assessment of risks and benefits are warranted in patients with active or recent GI bleeding or lesions. Whenever possible, especially if prolonged use is anticipated, treatment with non-ulcerogenic agents should be attempted first. If salicylates are used, close monitoring for toxicity is recommended. Some adverse GI effects may be minimized by administration with high dosages of antacids, use of enteric-coated or extended-release formulations, and/or concurrent use of a histamine H2-receptor antagonist or a cytoprotective agent such as misoprostol. Patients with active peptic ulceration or GI bleeding treated with salicylates should generally be administered a concomitant anti-ulcer regimen.
Gastrointestinal Hemorrhage
Major:
Mono-Gesic
The salsalate in Mono-Gesic has a major potential interaction with Gastrointestinal Hemorrhage.
Salicylates, particularly aspirin, can cause dose-related gastrointestinal bleeding and mucosal damage, which may occur independently of each other. Occult, often asymptomatic GI blood loss is quite common with usual dosages of aspirin and stems from the drug's local effect on the GI mucosa. During chronic therapy, this type of bleeding may occasionally produce iron deficiency anemia. In contrast, major upper GI bleeding rarely occurs except in patients with active peptic ulcers or recent GI bleeding. However, these patients generally do not experience greater occult blood loss than healthy patients following small doses of aspirin. Mucosal damage associated with the use of salicylates may lead to development of peptic ulcers with or without bleeding, reactivation of latent ulcers, and ulcer perforation. Therapy with salicylates and related agents such as salicylamide should be considered and administered cautiously in patients with a history of GI disease or alcoholism, particularly if they are elderly and/or debilitated, since such patients may be more susceptible to the GI toxicity of these drugs and seem to tolerate ulceration and bleeding less well than other individuals. Extreme caution and thorough assessment of risks and benefits are warranted in patients with active or recent GI bleeding or lesions. Whenever possible, especially if prolonged use is anticipated, treatment with non-ulcerogenic agents should be attempted first. If salicylates are used, close monitoring for toxicity is recommended. Some adverse GI effects may be minimized by administration with high dosages of antacids, use of enteric-coated or extended-release formulations, and/or concurrent use of a histamine H2-receptor antagonist or a cytoprotective agent such as misoprostol. Patients with active peptic ulceration or GI bleeding treated with salicylates should generally be administered a concomitant anti-ulcer regimen.
Gastrointestinal Perforation
Major:
Mono-Gesic
The salsalate in Mono-Gesic has a major potential interaction with Gastrointestinal Perforation.
Salicylates, particularly aspirin, can cause dose-related gastrointestinal bleeding and mucosal damage, which may occur independently of each other. Occult, often asymptomatic GI blood loss is quite common with usual dosages of aspirin and stems from the drug's local effect on the GI mucosa. During chronic therapy, this type of bleeding may occasionally produce iron deficiency anemia. In contrast, major upper GI bleeding rarely occurs except in patients with active peptic ulcers or recent GI bleeding. However, these patients generally do not experience greater occult blood loss than healthy patients following small doses of aspirin. Mucosal damage associated with the use of salicylates may lead to development of peptic ulcers with or without bleeding, reactivation of latent ulcers, and ulcer perforation. Therapy with salicylates and related agents such as salicylamide should be considered and administered cautiously in patients with a history of GI disease or alcoholism, particularly if they are elderly and/or debilitated, since such patients may be more susceptible to the GI toxicity of these drugs and seem to tolerate ulceration and bleeding less well than other individuals. Extreme caution and thorough assessment of risks and benefits are warranted in patients with active or recent GI bleeding or lesions. Whenever possible, especially if prolonged use is anticipated, treatment with non-ulcerogenic agents should be attempted first. If salicylates are used, close monitoring for toxicity is recommended. Some adverse GI effects may be minimized by administration with high dosages of antacids, use of enteric-coated or extended-release formulations, and/or concurrent use of a histamine H2-receptor antagonist or a cytoprotective agent such as misoprostol. Patients with active peptic ulceration or GI bleeding treated with salicylates should generally be administered a concomitant anti-ulcer regimen.
Hemodialysis
Moderate:
Mono-Gesic
The salsalate in Mono-Gesic has a moderate potential interaction with Hemodialysis.
Salicylate and its metabolites are readily removed by hemodialysis and, to a lesser extent, by peritoneal dialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.
High Blood Pressure
Moderate:
voclosporin
Voclosporin has a moderate potential interaction with High Blood Pressure.
The use of voclosporin causes hypertension. Exercise care when using this agent in hypertensive patients, including patients on antihypertensive drugs. It is recommended to monitor blood pressure regularly during treatment and treat new-onset hypertension and exacerbations of preexisting hypertension according to medical practices. If a patient experiences increases in blood pressure that cannot be managed with dose reduction or other appropriate medical intervention, consider treatment discontinuation.
History, Peptic Ulcer
Major:
Mono-Gesic
The salsalate in Mono-Gesic has a major potential interaction with History, Peptic Ulcer.
Salicylates, particularly aspirin, can cause dose-related gastrointestinal bleeding and mucosal damage, which may occur independently of each other. Occult, often asymptomatic GI blood loss is quite common with usual dosages of aspirin and stems from the drug's local effect on the GI mucosa. During chronic therapy, this type of bleeding may occasionally produce iron deficiency anemia. In contrast, major upper GI bleeding rarely occurs except in patients with active peptic ulcers or recent GI bleeding. However, these patients generally do not experience greater occult blood loss than healthy patients following small doses of aspirin. Mucosal damage associated with the use of salicylates may lead to development of peptic ulcers with or without bleeding, reactivation of latent ulcers, and ulcer perforation. Therapy with salicylates and related agents such as salicylamide should be considered and administered cautiously in patients with a history of GI disease or alcoholism, particularly if they are elderly and/or debilitated, since such patients may be more susceptible to the GI toxicity of these drugs and seem to tolerate ulceration and bleeding less well than other individuals. Extreme caution and thorough assessment of risks and benefits are warranted in patients with active or recent GI bleeding or lesions. Whenever possible, especially if prolonged use is anticipated, treatment with non-ulcerogenic agents should be attempted first. If salicylates are used, close monitoring for toxicity is recommended. Some adverse GI effects may be minimized by administration with high dosages of antacids, use of enteric-coated or extended-release formulations, and/or concurrent use of a histamine H2-receptor antagonist or a cytoprotective agent such as misoprostol. Patients with active peptic ulceration or GI bleeding treated with salicylates should generally be administered a concomitant anti-ulcer regimen.
Infection
Major:
voclosporin
Voclosporin has a major potential interaction with Infection.
Serious and sometimes fatal infections have been reported in patients receiving immunosuppressive agents. Patients receiving immunosuppressants are at increased risk of developing bacterial, viral, fungal, and protozoal infections, and new or reactivated viral infections including opportunistic infections. Caution should be exercised when considering their use in patients with severe or chronic infections. It is recommended to interrupt therapy in patients who develop a new infection while undergoing treatment and to monitor these patients closely for any sign or symptom indicative of infection.
Moderate:
voclosporin
Voclosporin has a moderate potential interaction with Infection.
Calcineurin-inhibitors, may cause pure red cell aplasia (PRCA). Care should be exercised when using voclosporin in patients at risk for PRCA, such as parvovirus B19 infection, underlying disease, or concomitant medications associated with PRCA. It is recommended to consider treatment discontinuation if PRCA is diagnosed.
Influenza
Major:
Mono-Gesic
The salsalate in Mono-Gesic has a major potential interaction with Influenza.
The use of salicylates, primarily aspirin, in children with varicella infections or influenza-like illnesses has been associated with an increased risk of Reye's syndrome. Although a causal relationship has not been established, the majority of evidence to date seems to support the association. Most authorities, including the American Academy of Pediatrics Committee on Infectious Diseases, recommend avoiding the use of salicylates in children and teenagers with known or suspected varicella or influenza and during presumed outbreaks of influenza. If antipyretic or analgesic therapy is indicated under these circumstances, acetaminophen may be an appropriate alternative. The same precautions should also be observed with related agents such as salicylamide or diflunisal because of their structural and pharmacological similarities to salicylate.
Liver Disease
Major:
voclosporin
Voclosporin has a major potential interaction with Liver Disease.
Voclosporin is predominantly metabolized by CYP450 3A4. Avoid the use of voclosporin in patients with severe hepatic impairment (Child-Pugh C). It is recommended to reduce the dose of voclosporin to 15.8 mg twice a day in patients with mild and moderate hepatic impairment (Child-Pugh A and Child-Pugh B).
Moderate:
Mono-Gesic
The salsalate in Mono-Gesic has a moderate potential interaction with Liver Disease.
The use of salicylates has occasionally been associated with acute, reversible hepatotoxicity, primarily manifested as elevations of serum transaminases, alkaline phosphatase and/or, rarely, bilirubin. Hepatic injury consistent with chronic active hepatitis has also been reported in a few patients, which resulted rarely in encephalopathy or death. Salicylate-induced hepatotoxicity appears to be dependent on serum salicylate concentration (> 25 mg/dL) and has occurred most frequently in patients with juvenile arthritis, active systemic lupus erythematosus, rheumatic fever, or preexisting hepatic impairment. Therapy with salicylates, particularly when given in high dosages, should be administered cautiously in these patients, and periodic monitoring of liver function is recommended. The same precautions should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate. A dosage reduction may be necessary if liver function abnormalities develop and serum salicylate concentration exceeds 25 mg/dL, although serum transaminase elevations may sometimes be transient and return to pretreatment values despite continued therapy without dosage adjustment.
Neurological Disorders
Moderate:
voclosporin
Voclosporin has a moderate potential interaction with Neurological Disorders.
The use of voclosporin may cause a spectrum of neurotoxicities. It is recommended to monitor for neurologic symptoms and to consider dosage reduction or discontinuation if neurotoxicity occurs. Care should be exercised when using this drug in patients with preexisting neurological conditions such as seizures, delirium, posterior reversible encephalopathy syndrome.
Noninfectious Colitis
Major:
Mono-Gesic
The salsalate in Mono-Gesic has a major potential interaction with Noninfectious Colitis.
Salicylates, particularly aspirin, can cause dose-related gastrointestinal bleeding and mucosal damage, which may occur independently of each other. Occult, often asymptomatic GI blood loss is quite common with usual dosages of aspirin and stems from the drug's local effect on the GI mucosa. During chronic therapy, this type of bleeding may occasionally produce iron deficiency anemia. In contrast, major upper GI bleeding rarely occurs except in patients with active peptic ulcers or recent GI bleeding. However, these patients generally do not experience greater occult blood loss than healthy patients following small doses of aspirin. Mucosal damage associated with the use of salicylates may lead to development of peptic ulcers with or without bleeding, reactivation of latent ulcers, and ulcer perforation. Therapy with salicylates and related agents such as salicylamide should be considered and administered cautiously in patients with a history of GI disease or alcoholism, particularly if they are elderly and/or debilitated, since such patients may be more susceptible to the GI toxicity of these drugs and seem to tolerate ulceration and bleeding less well than other individuals. Extreme caution and thorough assessment of risks and benefits are warranted in patients with active or recent GI bleeding or lesions. Whenever possible, especially if prolonged use is anticipated, treatment with non-ulcerogenic agents should be attempted first. If salicylates are used, close monitoring for toxicity is recommended. Some adverse GI effects may be minimized by administration with high dosages of antacids, use of enteric-coated or extended-release formulations, and/or concurrent use of a histamine H2-receptor antagonist or a cytoprotective agent such as misoprostol. Patients with active peptic ulceration or GI bleeding treated with salicylates should generally be administered a concomitant anti-ulcer regimen.
Peptic Ulcer
Major:
Mono-Gesic
The salsalate in Mono-Gesic has a major potential interaction with Peptic Ulcer.
Salicylates, particularly aspirin, can cause dose-related gastrointestinal bleeding and mucosal damage, which may occur independently of each other. Occult, often asymptomatic GI blood loss is quite common with usual dosages of aspirin and stems from the drug's local effect on the GI mucosa. During chronic therapy, this type of bleeding may occasionally produce iron deficiency anemia. In contrast, major upper GI bleeding rarely occurs except in patients with active peptic ulcers or recent GI bleeding. However, these patients generally do not experience greater occult blood loss than healthy patients following small doses of aspirin. Mucosal damage associated with the use of salicylates may lead to development of peptic ulcers with or without bleeding, reactivation of latent ulcers, and ulcer perforation. Therapy with salicylates and related agents such as salicylamide should be considered and administered cautiously in patients with a history of GI disease or alcoholism, particularly if they are elderly and/or debilitated, since such patients may be more susceptible to the GI toxicity of these drugs and seem to tolerate ulceration and bleeding less well than other individuals. Extreme caution and thorough assessment of risks and benefits are warranted in patients with active or recent GI bleeding or lesions. Whenever possible, especially if prolonged use is anticipated, treatment with non-ulcerogenic agents should be attempted first. If salicylates are used, close monitoring for toxicity is recommended. Some adverse GI effects may be minimized by administration with high dosages of antacids, use of enteric-coated or extended-release formulations, and/or concurrent use of a histamine H2-receptor antagonist or a cytoprotective agent such as misoprostol. Patients with active peptic ulceration or GI bleeding treated with salicylates should generally be administered a concomitant anti-ulcer regimen.
Posterior Reversible Encephalopathy Syndrome
Moderate:
voclosporin
Voclosporin has a moderate potential interaction with Posterior Reversible Encephalopathy Syndrome.
The use of voclosporin may cause a spectrum of neurotoxicities. It is recommended to monitor for neurologic symptoms and to consider dosage reduction or discontinuation if neurotoxicity occurs. Care should be exercised when using this drug in patients with preexisting neurological conditions such as seizures, delirium, posterior reversible encephalopathy syndrome.
Psychosis
Moderate:
voclosporin
Voclosporin has a moderate potential interaction with Psychosis.
The use of voclosporin may cause a spectrum of neurotoxicities. It is recommended to monitor for neurologic symptoms and to consider dosage reduction or discontinuation if neurotoxicity occurs. Care should be exercised when using this drug in patients with preexisting neurological conditions such as seizures, delirium, posterior reversible encephalopathy syndrome.
Pure Red Cell Aplasia
Moderate:
voclosporin
Voclosporin has a moderate potential interaction with Pure Red Cell Aplasia.
Calcineurin-inhibitors, may cause pure red cell aplasia (PRCA). Care should be exercised when using voclosporin in patients at risk for PRCA, such as parvovirus B19 infection, underlying disease, or concomitant medications associated with PRCA. It is recommended to consider treatment discontinuation if PRCA is diagnosed.
Renal Dysfunction
Major:
Mono-Gesic
The salsalate in Mono-Gesic has a major potential interaction with Renal Dysfunction.
Salicylate and its metabolites are eliminated almost entirely by the kidney. Therapy with salicylate drugs should be administered cautiously in patients with renal impairment, especially if it is severe. Reduced dosages may be necessary to avoid drug accumulation. Clinical monitoring of renal function is recommended during prolonged therapy, since the use of salicylate drugs has rarely been associated with renal toxicities, including elevations in serum creatinine, renal papillary necrosis, and acute tubular necrosis with renal failure. Most of the data have been derived from experience with aspirin but may apply to other salicylates as well. In patients with impaired renal function, aspirin has caused reversible and sometimes marked decreases in renal blood flow and glomerular filtration rate. Adverse renal effects have usually reversed rapidly following withdrawal of aspirin therapy.
Moderate:
voclosporin
Voclosporin has a moderate potential interaction with Renal Dysfunction.
The use of voclosporin, like other calcineurin-inhibitors, can cause acute and/or chronic nephrotoxicity. Voclosporin use is not recommended in patients with a baseline estimated glomerular filtration rate (eGFR) of 45 mL/min/1.73 m2 or less unless the benefit exceeds the risk. A reduced dose should be used when treating patients with severe renal impairment at baseline. No dosage adjustment is recommended in patients with mild or moderate renal impairment at baseline. It is recommended to establish a baseline eGFR and regularly monitor eGFR during treatment. Consideration should be given to the risks and benefits of voclosporin treatment in light of the patient's treatment response and risk of worsening nephrotoxicity. Consider dose reduction or discontinuation in patients with decreases in eGFR from baseline. Persistent decrease of eGFR should be evaluated for chronic calcineurin-inhibitor nephrotoxicity.
Seizures
Moderate:
voclosporin
Voclosporin has a moderate potential interaction with Seizures.
The use of voclosporin may cause a spectrum of neurotoxicities. It is recommended to monitor for neurologic symptoms and to consider dosage reduction or discontinuation if neurotoxicity occurs. Care should be exercised when using this drug in patients with preexisting neurological conditions such as seizures, delirium, posterior reversible encephalopathy syndrome.
Thrombocytopathy
Moderate:
Mono-Gesic
The salsalate in Mono-Gesic has a moderate potential interaction with Thrombocytopathy.
All salicylates can interfere with the action of vitamin K and induce a dose-dependent alteration in hepatic synthesis of coagulation factors VII, IX and X. At usual recommended dosages, a slight increase in prothrombin time (PT) may occur. Therapy with salicylates, especially if given in high dosages, should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. The same precaution should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.
Thrombocytopenia
Moderate:
Mono-Gesic
The salsalate in Mono-Gesic has a moderate potential interaction with Thrombocytopenia.
All salicylates can interfere with the action of vitamin K and induce a dose-dependent alteration in hepatic synthesis of coagulation factors VII, IX and X. At usual recommended dosages, a slight increase in prothrombin time (PT) may occur. Therapy with salicylates, especially if given in high dosages, should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. The same precaution should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.
Vaccination
Moderate:
voclosporin
Voclosporin has a moderate potential interaction with Vaccination.
The use of live vaccines should be avoided during treatment with voclosporin, including but not limited to the intranasal influenza, measles, mumps, rubella, oral polio, BCG, yellow fever, varicella, and TY21a typhoid vaccines. In addition, inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment with voclosporin.
Varicella-Zoster
Major:
Mono-Gesic
The salsalate in Mono-Gesic has a major potential interaction with Varicella-Zoster.
The use of salicylates, primarily aspirin, in children with varicella infections or influenza-like illnesses has been associated with an increased risk of Reye's syndrome. Although a causal relationship has not been established, the majority of evidence to date seems to support the association. Most authorities, including the American Academy of Pediatrics Committee on Infectious Diseases, recommend avoiding the use of salicylates in children and teenagers with known or suspected varicella or influenza and during presumed outbreaks of influenza. If antipyretic or analgesic therapy is indicated under these circumstances, acetaminophen may be an appropriate alternative. The same precautions should also be observed with related agents such as salicylamide or diflunisal because of their structural and pharmacological similarities to salicylate.
Vitamin K Deficiency
Moderate:
Mono-Gesic
The salsalate in Mono-Gesic has a moderate potential interaction with Vitamin K Deficiency.
All salicylates can interfere with the action of vitamin K and induce a dose-dependent alteration in hepatic synthesis of coagulation factors VII, IX and X. At usual recommended dosages, a slight increase in prothrombin time (PT) may occur. Therapy with salicylates, especially if given in high dosages, should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. The same precaution should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.
More resources
Mono-Gesic
A total of 352 drugs are known to interact with Mono-Gesic.
- Mono-gesic is in the drug class salicylates.
- Mono-gesic is used to treat the following conditions:
voclosporin
A total of 1019 drugs are known to interact with voclosporin.
- Voclosporin is in the drug class calcineurin inhibitors.
- Voclosporin is used to treat Lupus Nephritis.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
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