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Drug Interactions between Synercid and tacrolimus

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

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Interactions between your drugs

Major

tacrolimus dalfopristin

Applies to: tacrolimus and Synercid (dalfopristin / quinupristin)

GENERALLY AVOID: Based on in vitro inhibition data, coadministration with dalfopristin-quinupristin may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme, including certain agents that can cause prolongation of the QTc interval (e.g., cisapride, disopyramide, pimozide, quinidine, tacrolimus). High plasma levels of these agents have been rarely associated with ventricular arrhythmias including ventricular tachycardia, ventricular fibrillation, and torsade de pointes, as well as cardiac arrest and sudden death.

MANAGEMENT: Given the potential for serious and life-threatening adverse cardiac events associated with increased plasma levels of agents that may prolong the QTc interval, concomitant use with dalfopristin-quinupristin should be avoided if they are known to be substrates of CYP450 3A4.

References

  1. "Product Information. Synercid (dalfopristin-quinupristin)." Rhone Poulenc Rorer PROD (2001):

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Drug and food interactions

Moderate

tacrolimus food

Applies to: tacrolimus

ADJUST DOSING INTERVAL: Consumption of food has led to a 27% decrease in the bioavailability of orally administered tacrolimus.

MANAGEMENT: Tacrolimus should be administered at least one hour before or two hours after meals.

GENERALLY AVOID: Grapefruit juice has been reported to increase tacrolimus trough concentrations. Data are limited, but inhibition of the CYP450 enzyme system appears to be involved.

MANAGEMENT: The clinician may want to recommend that the patient avoid ingesting large amounts of grapefruit juice while taking tacrolimus.

References

  1. "Product Information. Prograf (tacrolimus)." Fujisawa PROD (2001):
  2. Hooks MA "Tacrolimus, a new immunosuppressant--a review of the literature." Ann Pharmacother 28 (1994): 501-11

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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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