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Drug Interactions between neomycin and sorafenib

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

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Interactions between your drugs

Moderate

neomycin SORAfenib

Applies to: neomycin and sorafenib

MONITOR: Coadministration with oral neomycin may decrease the bioavailability of sorafenib. The glucuronide conjugates of sorafenib are cleaved in the gastrointestinal tract by bacterial glucuronidase, which allows the unconjugated parent drug to be reabsorbed. Neomycin interferes with this enterohepatic recycling by suppressing bacteria with glucuronidase activity. In healthy volunteers, administration of sorafenib following pretreatment with oral neomycin 1 gram three times daily for 5 days resulted in a 54% reduction in sorafenib average systemic exposure (AUC). The effects of other antibiotics on sorafenib pharmacokinetics have not been studied.

MANAGEMENT: The possibility of a diminished therapeutic response to sorafenib should be considered during coadministration with oral neomycin.

References (4)
  1. (2005) "Product Information. Nexavar (sorafenib)." Bayer Pharmaceutical Inc
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. EMEA. European Medicines Agency (2007) EPARs. European Union Public Assessment Reports. http://www.ema.europa.eu/ema/index.jsp?curl=pages/includes/medicines/medicines_landingpage.jsp&mid
  4. Cerner Multum, Inc. "Australian Product Information."

Drug and food interactions

Moderate

SORAfenib food

Applies to: sorafenib

ADJUST DOSING INTERVAL: Food may reduce the oral absorption and bioavailability of sorafenib. According to the product labeling, sorafenib bioavailability was reduced by 29% when administered with a high-fat meal compared to administration in the fasted state. When given with a moderate-fat meal, bioavailability was similar to that in the fasted state.

MANAGEMENT: To ensure maximal and consistent oral absorption, sorafenib should be taken at least one hour before or two hours after eating.

References (1)
  1. (2005) "Product Information. Nexavar (sorafenib)." Bayer Pharmaceutical Inc

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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