Selected Immunosuppressants;Temsirolimus/Selected Macrolides
How the interaction occurs:
When these two medicines are taken together, your body may not be able to process your immunosuppressant, temsirolimus, or your antibiotic properly.
What might happen:
Your blood levels of your medicines may increase and cause toxic side effects.
What you should do about this interaction:
Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want to check the amount of medicine in your blood and may want to change the amount of medicine you take. Let your doctor know if you experience a decrease in the amount of urine you make.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this interaction and may be monitoring you for it. If your doctor prescribes these medicines together, it may be necessary to adjust the dose of tacrolimus or change you to a different medicine. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Rapamune (sirolimus) US prescribing information. Wyeth Pharmaceuticals March, 2013.
2.Kovarik JM, Beyer D, Bizot MN, Jiang Q, Shenouda M, Schmouder RL. Effect of multiple-dose erythromycin on everolimus pharmacokinetics. Eur J Clin Pharmacol 2005 Mar;61(1):35-8.
3.Claesson K, Brattstrom C, Burke JT. Sirolimus and erythromycin interaction: two cases. Transplant Proc 2001 May;33(3):2136.
4.Padhi ID, Long P, Basha M, Anandan JV. Interaction between tacrolimus and erythromycin. Ther Drug Monit 1997 Feb;19(1):120-2.
5.Jensen C, Jordan M, Shapiro R, Scantlebury V, Hakala T, Fung J, Starzl T, Venkataramanan R. Interaction between tacrolimus and erythromycin. Lancet 1994 Sep 17;344(8925):825.
6.Shaeffer MS, Collier D, Sorrell MF. Interaction between FK506 and erythromycin. Ann Pharmacother 1994 Feb;28(2):280-1.
7.Furlan V, Perello L, Jacquemin E, Debray D, Taburet AM. Interactions between FK506 and rifampicin or erythromycin in pediatric liver recipients. Transplantation 1995 Apr 27;59(8):1217-8.
8.Wolter K, Wagner K, Philipp T, Fritschka E. Interaction between FK 506 and clarithromycin in a renal transplant patient. Eur J Clin Pharmacol 1994; 47(2):207-8.
9.Katari SR, Magnone M, Shapiro R, Jordan M, Scantlebury V, Vivas C, Gritsch A, McCauley J, Starzl T, Demetris AJ, Randhawa PS. Clinical features of acute reversible tacrolimus (FK 506) nephrotoxicity in kidney transplant recipients. Clin Transplant 1997 Jun;11(3):237-42.
10.Christians U, Schmidt G, Bader A, Lampen A, Schottmann R, Linck A, Sewing KF. Identification of drugs inhibiting the in vitro metabolism of tacrolimus by human liver microsomes. Br J Clin Pharmacol 1996 Mar; 41(3):187-90.
11.Torisel (temsirolimus) US prescribing information. Wyeth Pharmaceuticals, Inc. June, 2011.