Erythromycin Docetaxel

The taxanes are practically insoluble in water and solubility is limited to mixtures of ethanol with poly-ethoxylated castor oil. They are generally administered in 3-24 hour infusions. The taxanes are for 90-95% plasma protein bound and primarily metabolized by P450 enzymes in the liver. Less than 10% is excreted in the urine as parent compounds. The elimination half-life of docetaxel is approximately 10 hours while that of paclitaxel has been vary-ingly reported between 5 and 50 hours. Inhibitors of the cytochrome P450 isoenzyme Cyp3A4, like keto-conazole and erythromycine, are contraindicated. 

Acyclovir Erythromycin Ivermectin Itraconazole Rifampin Actinomycin D Daunorubicin Doxorubicin Docetaxel Epirubicin Etoposide Imatinib Irinotecan Paclitaxel Vinblastine Vincristine Amprenavir Indinavir Nelfinavir Ritonavir Saquinavir Cyclosporine A Tacrolimus Digoxin Quinidine Verapamil Diltiazem Aldosterone Cortisol Corticosterone Dexamethasone Hydrocortisone Cyclosporine Metkephamid Enkephalin... 

DOCETAXEL ANTIBIOTICS -ERYTHROMYCIN t docetaxel levels Inhibition of CYP3A4-mediated metabolism of docetaxel is metabolized by enzymes that are moderately inhibited by erythromycin, leading to t levels and possible toxicity Cautious use, or consider use of azithromycin, which has little effect on CYP3A4 and is therefore not expected to interact with docetaxel... 

CYP3A4 Amitryptiline, Imipramin, Cyclosporine, Docetaxel, Epipodophyllotoxin, Erythromycin, Losartan, Diazepam, Carbamazepine, Nefadozone, Nifedipine, Omeprazole, Terfenadine, Chlorpyrifos (Insecticide), Testosterone, Estradiol, Progesterone, and synthetic sexual steroids... 

The case of pseudomembranous colitis and cholestatic jaundice in one patient was attributed to the combination of docetaxel and doxorubicin, but the patient was also receiving long-term treatment with erythromycin and omeprazole which may have contributed to the interaction by inhibiting docetaxel metabolism by the cytochrome P450 isoenzyme CYPSA." ... 

Based on in vitro studies, the manufacturers surest that CYP3A inhibitors (such as ketoconazole and erythromycin) will raise docetaxel levels, whereas CYP3A inducers (such as rifampicin (rifampin) and the barbiturates) will reduce docetaxel levels. This has been seen for ketoconazole. 

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