Slt Immunosuppressants;Temsirolimus/Nirmatrelvir-Ritonavir Interactions
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Very Serious. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Nirmatrelvir-ritonavir may slow down how quickly your body processes cyclosporine, everolimus, sirolimus, tacrolimus, or temsirolimus.
What might happen:
The amount of cyclosporine, everolimus, sirolimus, tacrolimus, or temsirolimus in your body may increase and cause more side effects than normal.
What you should do about this interaction:
Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these two medicines together. Your doctor may want to stop or change the dose of your medicine and check the amount of cyclosporine, everolimus, sirolimus, tacrolimus, or temsirolimus in your blood.Contact your healthcare professional if you experience any chest discomfort, dizziness, shaking, leg cramping, swelling, or any unusual stomach upset, headache, or skin irritation.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
- 1.Sandimmune (cyclosporine) US prescribing information. Novartis Pharmaceuticals Corporation September 2023.
- 2.Afinitor (everolimus) US prescribing information. Novartaris Pharmaceuticals Corporation February, 2020.
- 3.Zortress (everolimus) US prescribing information. Novartis Pharmaceuticals Corporation Sept, 2023.
- 4.Torisel (temsirolimus) US prescribing information. Wyeth Pharmaceuticals, Inc. March, 2018.
- 5.Prograf (tacrolimus) US prescribing information. Fujisawa Healthcare, Inc. November, 2022.
- 6.Paxlovid (nirmatrelvir tablets and ritonavir tablets) US prescribing information. Pfizer Inc. May, 2023.
- 7.Lange NW, Salerno DM, Jennings DL, Choe J, Hedvat J, Kovac DB, Scheffert J, Shertel T, Ratner LE, Brown RS Jr, Pereira MR. Nirmatrelvir/ritonavir use: Managing clinically significant drug-drug interactions with transplant immunosuppressants. Am J Transplant 2022 Jan 11.
- 8.DKumar AHumar MGIson DKaul EBlumberg NTheodoropoulos LDanziger-Isakov MMichaels SAitken. AST Statement on Oral Antiviral Therapy for COVID-19 for Organ Transplant Recipients..
- 9.Fyarro (sirolimus protein-bound particles for injectable susspension) US prescribing information. Aadi Bioscience, Inc. November, 2021.
- 10.Salerno DM, Jennings DL, Lange NW, Bley Kovac D, Shertel T, Chen JK, Hedvat J, Scheffert J, Brown RS Jr, Pereira MR. Early clinical experience with nirmatrelvir/ritonavir for treatment of COVID-19 in solid organ transplant recipients. Am J Transplant 2022 Mar 12.
- 11.Prikis M, Cameron A. Paxlovid (Nirmatelvir/Ritonavir) and Tacrolimus Drug-Drug Interaction in a Kidney Transplant Patient with SARS-2-CoV infection: A Case Report. Transplant Proc 2022 May 19.
- 12.Guzman Cordero C, Saez-Torres de Vicente M. Management of nirmatrelvir/ritonavir and tacrolimus interaction in kidney transplant recipients infected by COVID-19: a three-case series. Eur J Hosp Pharm 2022 Dec 19.
- 13.Dewey KW, Yen B, Lazo J, Seijo L, Jariwala R, Shah RJ, Quan D, Carpenter B, Paul Singer J, Breen K, Hays S, Florez R. Nirmatrelvir/ritonavir Use With Tacrolimus in Lung Transplant Recipients: A Single-center Case Series. Transplantation 2022 Oct 28.
- 14.Sindelar M, McCabe D, Carroll E. Tacrolimus Drug-Drug Interaction with Nirmatrelvir/Ritonavir (Paxlovid) Managed with Phenytoin. J Med Toxicol 2023 Jan;19(1):45-48.
- 15.Schneider J, Wobser R, Kahn W, Wagner D, Tanriver Y, Walz G. Nirmatrelvir/ritonavir treatment in SARS-CoV-2 positive kidney transplant recipients - a case series with four patients. BMC Nephrol 2023 Apr 15; 24(1):99.
- 16.Chen Y, Wan W, Yao X, Guan Y. Drug-drug interaction between paxlovid and tacrolimus in a patient with myasthenia gravis and SARS-CoV-2 infection. J Neuroimmunol 2023 Dec 15;385:578245.
- 17.Tomida T, Itohara K, Yamamoto K, Kimura T, Fujita K, Uda A, Kitahiro Y, Yokoyama N, Hyodo Y, Omura T, Yano I. A model-based pharmacokinetic assessment of drug-drug interaction between tacrolimus and nirmatrelvir/ritonavir in a kidney transplant patient with COVID-19. Drug Metab Pharmacokinet 2023 Dec;53:100529.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.