CANCIDASaAntibacterials/ Antimycotics: rifampin Antiepileptics: carbamazepine, phenytoin Antiretrovirals: efavirenz, nevirapine Steroids/ Immunosuppressants: cyclosporine, dexamethasone, tacrolimus |
Fluconazole16,aAntiretrovirals: zidovudine Bronchodilators: theophylline Diuretics: hydrochlorothiazide Gastric acid modifiers: cimetidine, cisapride Oral contraceptives: ethinyl estradiol, levonorgestrel Oral hypoglycemics: glipizide, glyburide, tolbutamide Psychotropic agents: phenytoin, short-acting benzodiazepines Steroids/ Immunosuppressants: cyclosporine, tacrolimus Others: rifabutin, rifampin, terfenadine, warfarin |
Voriconazole17,aAntiarrhythmics: quinidine Antineoplastics: vinblastine, vincristine Antiretrovirals: amprenavir, delavirdine, efavirenz, nelfinavir, nevirapine, ritonavir, saquinavir Gastric acid modifiers: cisapride, omeprazole Long-acting barbiturates: mephobarbital, phenobarbital Oral hypoglycemics: sulfonylureas Psychotropic agents: alprazolam, carbamazepine, midazolam, phenytoin, pimozide, triazolam Statins: atorvastatin Steroids/ Immunosuppressants: cyclosporine, sirolimus, tacrolimus Others: astemizole, ergot alkaloids (ergotamine, dihydroergotamine), rifabutin, rifampin, terfenadine, warfarin |
AmBisome18,bNo formal clinical studies of drug interactions have been conducted with AmBisome. However, the following drugs are known to interact with amphotericin B and may interact with AmBisome: Antifungals: azoles (clotrimazole, fluconazole, ketoconazole, miconazole, etc), flucytosine Antineoplastic agents Corticosteroids Digitalis glycosides Leukocyte transfusions Other nephrotoxic medications Skeletal muscle relaxants |
|
Contraindications |
Contraindications |
Contraindications |
Contraindications |
a Drug categories that are derived from Gubbins et al do not necessarily indicate that the products listed interact with all the drugs in this category.19
b Drug categories as listed in AmBisome Prescribing Information.
Concomitant use of CANCIDAS with cyclosporine should be limited to patients for whom the potential benefit outweighs the potential risk of increased hepatic enzyme abnormalities. See the Warning in the Prescribing Information.
Unlike Azoles, CANCIDAS Is Not an Inhibitor of the Cytochrome P450 System16,17
- In vitro studies demonstrate that CANCIDAS is not an inhibitor of any enzyme in the cytochrome P450 system, is not a substrate for P-glycoprotein, and is a poor substrate for cytochrome P450 enzymes.
References
- CANCIDAS is contraindicated in patients with hypersensitivity to any component of this product.
- Laboratory abnormalities in liver function tests have been seen in healthy volunteers and patients treated with CANCIDAS. In some patients with serious underlying conditions who were receiving multiple concomitant medications along with CANCIDAS, clinical hepatic abnormalities have also occurred. Isolated cases of significant hepatic dysfunction, hepatitis, or worsening hepatic failure have been reported in patients; a causal relationship to CANCIDAS has not been established. Patients who develop abnormal liver function tests during therapy with CANCIDAS should be monitored for evidence of worsening hepatic function and evaluated for risk/benefit of continuing therapy with CANCIDAS.
- For patients receiving CANCIDAS and tacrolimus, standard monitoring of tacrolimus blood concentrations and appropriate tacrolimus dosage adjustments are recommended.
- Patients receiving rifampin should receive 70 mg of CANCIDAS daily. Patients receiving nevirapine, efavirenz, carbamazepine, dexamethasone, or phenytoin may require an increase in dose to 70 mg of CANCIDAS daily.
- Possible histamine-mediated symptoms have been reported, including rash, facial swelling, pruritus, sensation of warmth, and bronchospasm. Anaphylaxis has been reported during administration of CANCIDAS.
Before prescribing CANCIDAS, please read the Prescribing Information.
