Can you take Propulsid with Voclosporin?
1 drug interaction and 18 additional warnings found for the following 2 drugs:
- Propulsid (cisapride)
- voclosporin
Drug interactions
Major drug interactions
Major:
cisapride voclosporin
Applies to: Propulsid (cisapride) and voclosporin
Cisapride is no longer commercially available in the U.S. You should only take cisapride if you are prescribed the medication through an investigational limited access program and are closely monitored by your doctor.
Using cisapride together with voclosporin is not recommended. Combining these medications can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with either of these medications. 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:
cisapride Food/Lifestyle
Applies to: Propulsid (cisapride)
Cisapride is no longer on the market in the US. Do not take cisapride with any other medication, food, or beverage.
**Cisapride (Propulsid) is no longer marketed in the United States. You should only be taking cisapride if you are obtaining the medication from your doctor though a Limited Access Program developed jointly by the manufacturer and the FDA.**
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.
Disease interactions
16 potential interactions Applies to: 15 conditions, including High Blood Pressure, Seizures, Arrhythmia, Psychosis, and Liver Disease.
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.
Cardiovascular Conditions and Disorders
Major:
Propulsid
The cisapride in Propulsid has a major potential interaction with Cardiovascular Conditions and Disorders.
The use of cisapride is contraindicated in patients with cardiac disease. Serious cardiac arrhythmias, including ventricular arrhythmias and torsades de pointes associated with QT prolongation have been rarely associated with the use of cisapride, especially when taken in conjunction with other medications known to prolong the QT interval.
Gastrointestinal Hemorrhage
Major:
Propulsid
The cisapride in Propulsid has a major potential interaction with Gastrointestinal Hemorrhage.
The use of cisapride is contraindicated in patients with gastrointestinal hemorrhage, mechanical obstruction, or perforation. Enhanced gastrointestinal motility could be harmful in these patients.
Gastrointestinal Obstruction
Major:
Propulsid
The cisapride in Propulsid has a major potential interaction with Gastrointestinal Obstruction.
The use of cisapride is contraindicated in patients with gastrointestinal hemorrhage, mechanical obstruction, or perforation. Enhanced gastrointestinal motility could be harmful in these patients.
Gastrointestinal Perforation
Major:
Propulsid
The cisapride in Propulsid has a major potential interaction with Gastrointestinal Perforation.
The use of cisapride is contraindicated in patients with gastrointestinal hemorrhage, mechanical obstruction, or perforation. Enhanced gastrointestinal motility could be harmful in these patients.
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.
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.
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).
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.
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
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.
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.
More resources
Propulsid
A total of 417 drugs are known to interact with Propulsid.
- Propulsid is in the drug class GI stimulants.
- Propulsid 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
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.