Zidovudine drug interactions

Little information on the drug interactions of ribavirin is available. In vitro, ribavirin inhibits the phosphorylation reactions that are required for activation of zidovudine and stavudine. 

C. Myelotoxicity is associated with certain NRTIs such as zidovudine. Fat redistribution, drug interactions involving CYP3A4, dyslipidemia, and diabetic symptoms are all side effects common to the protease inhibitors. 

Drug Interactions According to the product label, interactions between Intron A and other drugs have not been fully evaluated. Caution should be exercised when administering Intron A therapy in combination with other potentially myelo-suppressive agents such as zidovudine. Concomitant use of alfa interferon and theophylline decreases theophylline clearance, resulting in a 100% increase in serum theophylline levels. 

Drug interactions Vitravene is not recommended for use in patients who have recently (2-4 weeks) been treated with either intravenous or intravitreal cidofovir because of the risk of exaggerated ocular inflammation. Results from in vitro tests demonstrated no inhibition of anti-CMV activity of fomivirsen by zidovudine or zalcitabine. 

Contraindications to interferon alfa therapy include hepatic decompensation, autoimmune disease, and history of cardiac arrhythmia. Caution is advised in the setting of psychiatric disease, epilepsy, thyroid disease, ischemic cardiac disease, severe renal insufficiency, and cytopenia. Alfa interferons are abortifacient in primates and should not be administered in pregnancy. Potential drug-drug interactions include increased theophylline levels and increased methadone levels. Co-administration with didanosine is not recommended because of a risk of hepatic failure, and co-administration with zidovudine may exacerbate cytopenias. 

Drug Interactions Zidovudine Probenecid Imipenem-cilastatin Dapsone Pentamidine Flucytosine Vincristine Vinblastine Adriamycin Amphotericin B TMP-SMX Other nucleoside analogues... 

Drug Interactions Antineoplastlc agents Corticosteroids and corticotropin Cyclosporine-A Digitalis glycosides Flucytosine Imidazoles Leukocyte transfusions Nephrotoxic medications Skeletal muscle relaxants Zidovudine... 

Burger DM, Meenhorst PL, Koks CH, Beijnen JH. Drug interactions with zidovudine. AIDS 1993 7(4) 445-60. 

Gustavson LE, Chu SY, Mackenthun A, Gupta MS, Craft JC. Drug interaction between clarithromycin and oral zidovudine in HIV-1 infected patients. Clin Pharmacol Ther 1993 53 163. 

Indinavir For use with zidovudine and lamivudine in cases where there is an increased risk for HIV transmission (i.e., source has high viral titer or large volume exposure) Expanded regimen Zidovudine 300 mg BID, lamivudine 150 mg BID, and indinavir 800 mg TID for 28 days Dose-related hyperbilirubinemia, nephrolithiasis, metallic taste, rash, dry mouth/ mucous membranes Hepatic elimination Give with water at least 1 hr prior, or 2 hr after a meal food will substantially reduce bioavailability Minimum of 48 oz fluids daily to reduce nephrolithiasis Numerous drug interactions... 

Studies of the concomitant use of azithromycin with carbamazepine, terfenadine, and zidovudine have not reported drug interactions [131-133]. With the potential exception of antacids, no drug interactions have been reported with azithromycin, which does not appear to be metabolized by the cytochrome P-450 system [4, 134], Both azithromycin and clarithromycin have been associated with digoxin toxicity. The postulated mechanism is by eradication of Eubacterium lentum, an anaerobic gram-positive bacteria responsible for the metabolism of digoxin in some patients [43]. 

Drug interactions Drugs that undergo hepatic glucuronidation, including acetaminophen, benzodiazepines, cimetidine, and sulfonamides, may increase plasma levels of zidovudine. Metabolism of zidovudine may also be inhibited by azole antifungals and by protease inhibitors. Rifampin increases the clearance of zidovudine. 

Burger DM Meenhorst PL, ten Napel CHH, Mulder JW, Neef C, Koks CHW, Bull A, Bei-jnen JH. Pharmacokinetic variability of zidovudine in HIV-infected individuals sutgroup analysis and drug interactions. AIDS (1994) 8,1683-9. 

Antoniou T, Gough K, Yoor D, Arbess G. Severe anemia secondary to a probable drug interaction between zidovudine and valproic acid. CUn IrtfectDis (2004) 38, e38-40. 

Gallo JM, Swagler AR, Mehta M, Qian M. Pharmacokinetic evaluation of drug interactions with anti-human immunodeficiency virus drugs. VI. Effect of the calcium channel blocker nimodipine on zidovudine kinetics inmonkeys. JPharmacolExp Ther( 993) 264,315-20. 

Drugs that may interact with foscarnet include nephrotoxic drugs (eg, aminoglycosides, amphotericin B, IV pentamidine), pentamidine, and zidovudine. Foscarnet decreases serum levels of ionized calcium. Exercise particular caution when other drugs known to influence serum calcium levels are used concurrently. 

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

Drugs that may interact with stavudine include didanosine, doxorubicin, hydroxyurea, methadone, ribavirin, and zidovudine. 

Drugs that may interact include rifamycins, TMP-SMZ, and zidovudine. 

WARNING Renal impair is the major tox foUow administration instructions Uses CMV retinitis w/ HIV Action Selective inhibition of viral DNA synth Dose Rx 5 mg/kg IV over 1 h once/wk for 2 wk w/ probenecid Maint 5 mg/kg IV once/2 wk w/ probenecid (2 g PO 3 h prior to cidofovir, then 1 g PO at 2 h 8 h after cidofovir) X in renal impair Caution [C, -] Contra Probenecid or sulfa allergy Disp Inj SE Renal tox, chills, fever, HA, NA /D, thrombocytopenia, neutropenia Interactions t Nephrotox W/ aminoglycosides, amphot icin B, foscar-net, IV pentamidine, NSAIDs, vancomycin t effects W/zidovudine EMS Monitor ECG for hypocalcemia (t QT int val) and hypokalemia (flattened T waves) OD May cause renal failure hydration may be effective in reducing drug levels/effects Cilostazol (Pletal) TAntiplatelet, Arterial Vasodilator/ Phosphodiesterase Inhibitor] Uses Reduce Sxs of intermittent claudication Action Phosphodiesterase in inhibitor t s cAMP in pits blood vessels, vasodilation inhibit pit aggregation Dose 100 mg PO bid, 1/2 h before or 2 h after breakfast dinner Caution [C, +/-] Contra CHE, hemostatic disorders. 

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