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Drug Interaction Report

2 potential interactions and/or warnings found for the following 2 drugs:

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Interactions between your drugs

Major

rosuvastatin tafamidis

Applies to: ezetimibe / rosuvastatin, tafamidis

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration with tafamidis may increase the plasma concentrations of rosuvastatin. The proposed mechanism is inhibition of intestinal and hepatic breast cancer resistance protein (BCRP) efflux transporter by tafamidis, resulting in increased oral bioavailability and reduced hepatic clearance of rosuvastatin. When a single 10 mg dose of rosuvastatin was administered following pretreatment with tafamidis (61 mg twice daily on days 1 and 2, followed by 61 mg once daily on days 3 to 9) in healthy volunteers, mean rosuvastatin peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 86% and 97%, respectively, compared to administration of rosuvastatin alone. High levels of HMG-CoA reductase inhibitory activity in plasma may be associated with an increased risk of musculoskeletal toxicity. Myopathy manifested as muscle pain and/or weakness associated with grossly elevated creatine kinase exceeding ten times the upper limit of normal has been reported occasionally. Rhabdomyolysis has also occurred rarely, which may be accompanied by acute renal failure secondary to myoglobinuria and may result in death.

MANAGEMENT: According to the prescribing information for rosuvastatin, concomitant use with tafamidis should be avoided when possible because tafamidis alone may cause myopathy and the risk may be increased in combination with rosuvastatin. If coadministration is required, the dosage of rosuvastatin should start at 5 mg and not exceed 20 mg once daily. Alternatively, a different statin that is not expected to be significantly affected by BCRP inhibition such as pitavastatin or pravastatin may be considered. All patients receiving statin therapy should be advised to promptly report any unexplained muscle pain, tenderness or weakness, particularly if accompanied by fever, malaise and/or dark colored urine. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.

Moderate

ezetimibe rosuvastatin

Applies to: ezetimibe / rosuvastatin, ezetimibe / rosuvastatin

Using ezetimibe together with rosuvastatin can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness while taking these medications, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. 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.

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Drug and food interactions

No alcohol/food interactions were found with the drugs in your list. However, this does not necessarily mean no food interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

No duplication 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.


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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.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.