Drug Interactions between temsirolimus and voriconazole
This report displays the potential drug interactions for the following 2 drugs:
- temsirolimus
- voriconazole
Interactions between your drugs
voriconazole temsirolimus
Applies to: voriconazole and temsirolimus
GENERALLY AVOID: Coadministration of temsirolimus with potent inhibitors of CYP450 3A4 may significantly increase 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 CYP450 3A4 inhibitor ketoconazole resulted in a 2.2-fold and 3.1-fold increase 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.
MANAGEMENT: Concomitant use of temsirolimus with potent CYP450 3A4 inhibitors should generally be avoided. Some authorities recommend avoiding concomitant use of intravenous temsirolimus during and for 2 weeks after treatment with itraconazole (US). If coadministration is required, the manufacturer recommends reducing the temsirolimus dosage to 12.5 mg once a week. Based on pharmacokinetic studies, this dosage is predicted to adjust the sirolimus systemic exposure (AUC) to the range observed without inhibitors. However, clinical data are lacking. Following discontinuation of the potent CYP450 3A4 inhibitor, a washout period of approximately one week should be allowed before the temsirolimus dosage is adjusted upward to the normally recommended dosage (i.e., 25 mg once a week) or the dosage used prior to initiation of the CYP450 3A4 inhibitor.
References (3)
- (2002) "Product Information. Sporanox (itraconazole)." Janssen Pharmaceuticals
- (2007) "Product Information. Torisel (temsirolimus)." Wyeth-Ayerst Laboratories
- Cerner Multum, Inc. "Australian Product Information."
Drug and food interactions
voriconazole food
Applies to: voriconazole
ADJUST DOSING INTERVAL: Food reduces the oral absorption and bioavailability of voriconazole. According to the product labeling, administration of multiple doses of voriconazole with high-fat meals decreased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 34% and 24%, respectively, when the drug is administered as a tablet, and by 58% and 37%, respectively, when administered as the oral suspension.
MANAGEMENT: To ensure maximal oral absorption, voriconazole tablets and oral suspension should be taken at least one hour before or after a meal.
References (2)
- (2002) "Product Information. VFEND (voriconazole)." Pfizer U.S. Pharmaceuticals
- Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT (2009) "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm, 66, p. 1438-67
temsirolimus food
Applies to: 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)
- (2007) "Product Information. Torisel (temsirolimus)." Wyeth-Ayerst Laboratories
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
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.
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