Acyclovir drug interactions

The potential for drug interactions, particularly with other drugs that are actively secreted by the proximal tubules, should be considered. Probenecid has been shown to inhibit the renal clearance of acyclovir. Cyclosporine and other nephrotoxic agents may increase the risk of renal toxicity of acyclovir. 

Drug interactions In a randomized, double-blind study, Zenapax or placebo was added to an immunosuppressive regimen of cyclosporine, mycophenolate mofetil, and steroids to assess tolerability, pharmacokinetics, and drug interactions. The addition of Zenapax did not result in an increased incidence of adverse events or a change in the types of adverse events reported. The following medications have been administered in clinical trials with Zenapax with no incremental increase in adverse reactions cyclosporine, mycophenolate mofetil, ganciclovir, acyclovir, azathioprine, and corticosteroids. 

Drug Interactions Acyclovir Antacids with magnesium and aluminum hydroxides Cholestyramine Drugs that alter gastrointestinal flora may interact with mycophenolate mofetil by disrupting enterohepatic recirculation Probenecid... 

Sinko, P. J., and Balimane, P. V. Carrier-mediated intestinal absorption of valacyclovir, the L-valyl ester prodrug of acyclovir I. Interactions with peptides, organic anions and organic cations in rats. Biopharm. Drug Dispos. 19(4) 209-217, 1998. 

Sulfa ted amphiphilic a-, p-, and y-CDs were demonstrated to form 1 1 inclusion complexes with the antiviral drug acyclovir. Noncovalent interactions between... 

Shah J, Juan D, Bullingham R, Wong B, Wong R, Fu C. A single dose drug interaction study of mycophenolate mofetil and acyclovir in normal subjects. J Clin Pharmacol (1994) 34, 1029. 

S3mtex. A single-dose, pharmacokinetic drug interaction study of oral mycophenolate mofetil and oral acyclovir in normal subjects. Data on file, 1994. 

Bach MC. Possible drug interaction during therapy with azidod midine and acyclovir for ADDS. NEngUMedimi) 316, 547. 

An in vitro and in vivo study showed a drug interaction between penicillin and acyclovir by means of inhibition of OATl and OATS transporters, subsequently decreasing the renal excretion of acyclovir. Patients should be monitored closely for acyclovir adverse effects when given in combination with penicillin [45 ]. 

Drugs that may interact with acyclovir include hydantoins, probenecid, theophylline, valproic acid, and zidovudine. 

Probenecid has been reported to inhibit renal elimination of many drugs acyclovir (325,326), allopurinol (327), bumetanide (328), cephalosporins (329-334), cidofovir (335), ciprofloxacin (336), famotidine (337), fexofenadine (338), furosemide (339), and oseltamivir (Ro 64-0802) (340). Recent studies have elucidated that probenecid is a potent inhibitor of renal organic anion transporters (OAT1 and OAT3) with the Ki values lower than the unbound plasma concentration of probenecid, indicating the interaction with probenecid includes inhibition of the basolateral uptake process mediated by OAT1 and/or OAT3. 

In a further study, citric acid has been found to form an amorphous mixture with the antiviral drug acyclovir upon co-precipitation from N, N-dimethylformamide (Masuda et al. 2012). The molar ratio of acyclovir and citric acid was determined to be 1 2 in the co-precipitates. The miscibility of the components in the amorphous mixture was indicated by a single Tg value (68 °C) and the presence of hydrogen bonding interactions between acyclovir and citric acid. The formation of the amorphous mixture offered a significant improvement of skin permeation flux of the amorphous form from a polyethylene glycol (PEG) ointment in vitro compared to crystalline acyclovir. 

Masuda T, Yoshihashi Y, Yonemochi E, Fuji K, Uekusa H, Terada K (2012) CocrystaUization and amorphization induced by drug-excipient interaction improves the physical properties of acyclovir. Int J Pharm 422 160-169... 

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