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Drug Interactions between nicotinamide and Torisel

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

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Interactions between your drugs

Moderate

niacin temsirolimus

Applies to: nicotinamide and Torisel (temsirolimus)

MONITOR: Higher dosages of lipid-lowering agents may be required during concomitant administration of sirolimus or temsirolimus. Dose-related serum lipid abnormalities, including but not limited to increased serum cholesterol and triglycerides, have been frequently reported in patients treated with sirolimus or temsirolimus.

MANAGEMENT: Close clinical monitoring of serum cholesterol and triglycerides is recommended if sirolimus or temsirolimus is prescribed to patients receiving lipid-lowering agents. Modification of the antihyperlipidemic regimen or dosages may be necessary.

References (2)
  1. (2001) "Product Information. Rapamune (sirolimus)." Wyeth-Ayerst Laboratories
  2. (2007) "Product Information. Torisel (temsirolimus)." Wyeth-Ayerst Laboratories

Drug and food interactions

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
Moderate

niacin food

Applies to: nicotinamide

GENERALLY AVOID: Ethanol can exacerbate the cutaneous flushing that is a common side effect of niacin. At least one case of delirium and lactic acidosis has been reported with coadministration of these drugs, although data are limited.

MANAGEMENT: Coadministration should probably be discouraged, particularly since chronic consumption of large amounts of alcohol is associated with hyperlipidemia.

References (1)
  1. Schwab RA, Bachhuber BH (1991) "Delirium and lactic acidosis caused by ethanol and niacin coingestion." Am J Emerg Med, 9, p. 363-5
Minor

niacin food

Applies to: nicotinamide

A single case has been reported in which cutaneous flushing and tremors were noted in a woman who was taking niacin while wearing a nicotine patch. The mechanism is suspected to be synergistic cutaneous vasodilatory effects. The clinical significance of this possible interaction is not known.

References (1)
  1. Rockwell KA Jr (1993) "Potential interaction between niacin and transdermal nicotine." Ann Pharmacother, 27, p. 1283-8

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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