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Drug Interactions between mycophenolic acid and Torisel

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

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Interactions between your drugs

Moderate

mycophenolic acid temsirolimus

Applies to: mycophenolic acid and Torisel (temsirolimus)

MONITOR: Coadministration with sirolimus may increase the plasma concentrations of mycophenolic acid. The mechanism of interaction is unknown. In 13 kidney transplant patients receiving concomitant therapy with sirolimus, the mycophenolic acid systemic exposure (AUC from 0 to 12 hours) at 2 weeks, 1 month and 2 months post-transplantation was 88%, 50% and 49% higher, respectively, than in 17 patients receiving concomitant therapy with cyclosporine. At all time points, patients in the sirolimus group had significantly higher dose-normalized mycophenolic acid AUC values than patients in the cyclosporine group. In addition, at months 1 and 2, white blood cell counts were significantly lower in the sirolimus group than in the cyclosporine group. Theoretically, the interaction may also occur with temsirolimus, a drug that is primarily metabolized to sirolimus in vivo.

MANAGEMENT: Mycophenolic acid plasma levels should be monitored more closely following initiation, discontinuation, or change of dosage of sirolimus or temsirolimus.

References (1)
  1. Buchler M, Lebranchu Y, Beneton M, et al. (2005) "Higher exposure to mycophenolic acid with sirolimus than with cyclosporine cotreatment." Clin Pharmacol Ther, 78, p. 34-42

Drug and food interactions

Moderate

mycophenolic acid food

Applies to: mycophenolic acid

ADJUST DOSING INTERVAL: Administration of enteric coated mycophenolic acid with meals may alter its pharmacokinetics relative to administration in the fasting state. When mycophenolic acid 720 mg was administered with a high-fat meal, there was a 33% decrease in the peak plasma concentration (Cmax); a 3.5-hour increase in delay time for the rise of plasma mycophenolic acid; and a 5-hour delay in the time to reach peak plasma concentration (Tmax). However, no effect was observed on the systemic exposure of mycophenolic acid.

MANAGEMENT: To avoid variability in drug absorption between doses, enteric coated formulations of mycophenolic acid should be taken on an empty stomach, one hour before or two hours after food intake. The tablets should be swallowed whole and not crushed, chewed or divided in order to maintain the integrity of the enteric coating.

References (1)
  1. (2004) "Product Information. Myfortic (mycophenolic acid)." Novartis Pharmaceuticals
Moderate

temsirolimus food

Applies to: Torisel (temsirolimus)

GENERALLY AVOID: Coadministration of temsirolimus with grapefruit juice may increase the plasma concentrations of sirolimus, a major active metabolite of temsirolimus and known substrate of CYP450 3A4. The proposed mechanism is inhibition of CYP450 3A4-mediated metabolism by certain compounds present in grapefruits.

MANAGEMENT: Patients treated with temsirolimus should preferably avoid the consumption of grapefruit or grapefruit juice.

References (1)
  1. (2007) "Product Information. Torisel (temsirolimus)." 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.

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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

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