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Drug Interactions between Nallpen and Torisel

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

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Interactions between your drugs

Moderate

nafcillin temsirolimus

Applies to: Nallpen (nafcillin) and Torisel (temsirolimus)

GENERALLY AVOID: Coadministration of temsirolimus with inducers of CYP450 3A4 may decrease the plasma concentrations of sirolimus, a major active metabolite of temsirolimus and known substrate of CYP450 3A4. According to the product labeling, administration of temsirolimus in combination with the potent CYP450 3A4 inducer rifampin, resulted in a 65% and 56% decrease in sirolimus peak plasma concentration (Cmax) and systemic exposure (AUC), respectively, compared to administration of temsirolimus alone. No significant effect on the pharmacokinetics of temsirolimus was reported. The extent to which other inducers of CYP450 3A4 interact with temsirolimus is unknown.

MANAGEMENT: In the setting of mantle cell lymphoma, concomitant use of temsirolimus with inducers of CYP450 3A4 should generally be avoided. When used for the treatment of renal cell carcinoma, some authorities advise a dose increase from the recommended 25 mg IV once weekly to 50 mg IV once weekly depending on patient tolerability. Based on pharmacokinetic studies, this dosage is predicted to adjust the sirolimus AUC to the range observed without inducers; however, clinical data are lacking. The dosage should be reduced to the normally recommended dose following discontinuation of the potent CYP450 3A4 inducer. Other authorities also advise that temsirolimus should not be used in combination with CYP450 3A4 inducers for longer than 5 to 7 days in these patients.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. "Product Information. Torisel (temsirolimus)." Wyeth-Ayerst Laboratories (2007):
  3. Cerner Multum, Inc. "Australian Product Information." O 0

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Drug and food interactions

Moderate

nafcillin food

Applies to: Nallpen (nafcillin)

ADJUST DOSING INTERVAL: Certain penicillins may exhibit reduced gastrointestinal absorption in the presence of food. The therapeutic effect of the antimicrobial may be reduced.

MANAGEMENT: The interacting penicillin should be administered one hour before or two hours after meals. Penicillin V and amoxicillin are not affected by food and may be given without regard to meals.

References

  1. Neu HC "Antimicrobial activity and human pharmacology of amoxicillin." J Infect Dis 129 (1974): s123-31
  2. Welling PG, Huang H, Koch PA, Madsen PO "Bioavailability of ampicillin and amoxicillin in fasted and nonfasted subjects." J Pharm Sci 66 (1977): 549-52
  3. McCarthy CG, Finland M "Absorption and excretion of four penicillins." N Engl J Med 263 (1960): 315-26
  4. Cronk GA, Wheatley WB, Fellers GF, Albright H "The relationship of food intake to the absorption of potassium alpha-phenoxyethyl penicillin and potassium phenoxymethyl penicillin from the gastrointestinal tract." Am J Med Sci 240 (1960): 219-25
  5. Klein JO, Sabath LD, Finland M "Laboratory studies on oxacillin. I: in vitro activity against staphylococci and some other bacterial pathogens. II: absorption and urinary excretion in normal young." Am J Med Sci 245 (1963): 399-411
  6. Neuvonen PJ, Elonen E, Pentikainen PJ "Comparative effect of food on absorption of ampicillin and pivampicillin." J Int Med Res 5 (1977): 71-6
View all 6 references

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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. "Product Information. Torisel (temsirolimus)." Wyeth-Ayerst Laboratories (2007):

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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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