تداخلات ميثوتريكسات

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (نشرة أداليموماب، تحذير مؤطر)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

An increased risk of hepatitis has been reported to result from combined use of methotrexate and etretinate. (نشرة أسيتريتين، موانع الاستعمال)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (نشرة إنفليكسيماب، تحذير مؤطر)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (نشرة أوباداسيتينيب، تحذير مؤطر)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (نشرة إيتانرسبت، تحذير مؤطر)

Immunosuppressants Everolimus Sirolimus Temsirolimus (IV) Not recommended during and 2 weeks after TOLSURA treatment. (نشرة إيتراكونازول، التداخلات الدوائية)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Most patients with rheumatoid arthritis who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (نشرة باريسيتينيب، تحذير مؤطر)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

…IN TRANSPLANT PATIENTS; AND INCREASED MORTALITY IN FEMALE LIVER TRANSPLANT PATIENTS • Increased risk for developing serious infections and malignancies with ASTAGRAF XL ® or other immunosuppressants that may lead to hospitalization or death. [see Warnings and Precautions ( 5.1 , 5.2 )] • Increased mortality in female liver transplant patients with ASTAGRAF XL. (نشرة تاكروليموس، تحذير مؤطر)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (نشرة توسيليزوماب، تحذير مؤطر)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (نشرة توفاسيتينيب، تحذير مؤطر)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Immunosuppressant/neoplastic: everolimus Co-administration of everolimus and PREZISTA/ritonavir is not recommended. irinotecan Discontinue PREZISTA/ritonavir at least 1 week prior to starting irinotecan therapy. (نشرة دارونافير، التداخلات الدوائية)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Use of KEVEYIS with drugs that are sensitive to OAT1 inhibition (e.g., methotrexate, famotidine, oseltamivir) is not recommended [see Clinical Pharmacology (12.3) ]. (نشرة ديكلورفيناميد، التداخلات الدوائية)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Coadministration of VOSEVI with BCRP substrates (e.g., methotrexate, mitoxantrone, imatinib, irinotecan, lapatinib, rosuvastatin, sulfasalazine, topotecan) is not recommended [see Clinical Pharmacology (12.3) ]. (نشرة سوفوسبوفير وفيلباتاسفير، التداخلات الدوائية)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Dihydrofolate Reductase (DHFR) Inhibitors : Avoid concomitant use (e.g., trimethoprim, methotrexate, trimetrexate, pemetrexed, pralatrexate, raltitrexed, or piritrexim). (نشرة سيبيابترين، التداخلات الدوائية)

In kidney, liver, and heart transplant patients Neoral may be administered with other immunosuppressive agents. (نشرة سيكلوسبورين، تحذير مؤطر)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Chicken pox and measles, for example, can have a more serious or even fatal course in children on immunosuppressant corticosteroids. (نشرة فلودروكورتيزون، التحذيرات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Persons who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chickenpox or measles. (نشرة فلونيسوليد، الاحتياطات)

Because of foscarnet's tendency to cause renal impairment, the use of FOSCAVIR should be avoided in combination with potentially nephrotoxic drugs such as aminoglycosides, amphotericin B, cyclosporine, acyclovir, methotrexate, tacrolimus and intravenous pentamidine (see above) unless the potential benefits outweigh the risks to the patient. (نشرة فوسكارنت، التداخلات الدوائية)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

…Prevention or Management: Phenytoin and antacids should not be taken at the same time of day Antineoplastic agents (usually in combination) Bleomycin, carboplatin, cisplatin, doxorubicin, methotrexate Antiviral agents Fosamprenavir, nelfinavir, ritonavir Antiepileptic drugs Carbamazepine, vigabatrin Other Chronic alcohol abuse, diazepam, diazoxide, folic acid, reserpine,… (نشرة فينيتوين، التداخلات الدوائية)

About 13 percent of the cases of neutropenia have ended fatally, but almost all fatalities were in patients with serious illness, having collagen vascular disease, renal failure, heart failure or immunosuppressant therapy, or a combination of these complicating factors. (نشرة كابتوبريل، التحذيرات)

Prevention or Management Concomitant use with myelosuppressive or other immunosuppressive drugs is not recommended. (نشرة كلادريبين، التداخلات الدوائية)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

…methylergonovine • HMG-CoA reductase inhibitors: lovastatin, simvastatin (these drugs can be temporarily discontinued to allow PAXLOVID use [see Table 2 , Drug Interactions (7.3) ] ) • Immunosuppressants: voclosporin • Microsomal triglyceride transfer protein inhibitor: lomitapide • Migraine medications: eletriptan, ubrogepant • Mineralocorticoid receptor antagonists:… (نشرة نيرماتريلفير وريتونافير، موانع الاستعمال)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (نشرة ميثوتريكسات، التحذيرات والاحتياطات)

Immunosuppressants: cyclosporine, sirolimus, tacrolimus ↑ immunosuppressants Therapeutic concentration monitoring is recommended for these immunosuppressants when coadministered with REYATAZ. (نشرة أتازانافير، التداخلات الدوائية)

Monitor patients receiving XATMEP with other potential hepatotoxins (e.g., azathioprine, retinoids, and sulfasalazine) for possible signs of hepatotoxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

Effect of XATMEP on Other Drugs Theophylline Methotrexate may decrease the clearance of theophylline. (نشرة ميثوتريكسات، التداخلات الدوائية)

Monitor patients receiving XATMEP with other potential hepatotoxins (e.g., azathioprine, retinoids, and sulfasalazine) for possible signs of hepatotoxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

…(e.g., atorvastatin, bosentan, ezetimibe, fluvastatin, glyburide, olmesartan, pitavastatin, pravastatin, rosuvastatin, repaglinide, rifampin, simvastatin acid, SN-38 [active metabolite of irinotecan], valsartan) or breast cancer resistance protein (BCRP) (e.g., imatinib, irinotecan, lapatinib, methotrexate, mitoxantrone, rosuvastatin, sulfasalazine, topotecan). (نشرة إلترومبوباغ، التداخلات الدوائية)

Immuno-suppressants: e.g., cyclosporine (CsA) sirolimus tacrolimus ↑ immuno-suppressants ↑ elvitegravir (with CsA) ↑ cobicistat (with CsA) Therapeutic monitoring of the immunosuppressive agents is recommended upon coadministration with GENVOYA. (نشرة إلفيتيغرافير وكوبيسيستات وإمتريسيتابين وتينوفوفير، التداخلات الدوائية)

Effect of XATMEP on Other Drugs Theophylline Methotrexate may decrease the clearance of theophylline. (نشرة ميثوتريكسات، التداخلات الدوائية)

Effect of Other Drugs on XATMEP Oral Antibiotics Penicillins may reduce the renal clearance of methotrexate; increased serum concentrations of methotrexate with concomitant hematologic and gastrointestinal toxicity have been observed with methotrexate. (نشرة ميثوتريكسات، التداخلات الدوائية)

Effect of Other Drugs on XATMEP Oral Antibiotics Penicillins may reduce the renal clearance of methotrexate; increased serum concentrations of methotrexate with concomitant hematologic and gastrointestinal toxicity have been observed with methotrexate. (نشرة ميثوتريكسات، التداخلات الدوائية)

Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (نشرة أملوديبين، التداخلات الدوائية)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (نشرة أملوديبين وأتورفاستاتين، التداخلات الدوائية)

Immunosuppressants: Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (نشرة أملوديبين وأولميسارتان، التداخلات الدوائية)

Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when coadministered. (نشرة أملوديبين وفالسارتان، التداخلات الدوائية)

Effect of Other Drugs on XATMEP Oral Antibiotics Penicillins may reduce the renal clearance of methotrexate; increased serum concentrations of methotrexate with concomitant hematologic and gastrointestinal toxicity have been observed with methotrexate. (نشرة ميثوتريكسات، التداخلات الدوائية)

Effect of Other Drugs on XATMEP Oral Antibiotics Penicillins may reduce the renal clearance of methotrexate; increased serum concentrations of methotrexate with concomitant hematologic and gastrointestinal toxicity have been observed with methotrexate. (نشرة ميثوتريكسات، التداخلات الدوائية)

Effect of XATMEP on Other Drugs Theophylline Methotrexate may decrease the clearance of theophylline. (نشرة ميثوتريكسات، التداخلات الدوائية)

Effect of Other Drugs on XATMEP Oral Antibiotics Penicillins may reduce the renal clearance of methotrexate; increased serum concentrations of methotrexate with concomitant hematologic and gastrointestinal toxicity have been observed with methotrexate. (نشرة ميثوتريكسات، التداخلات الدوائية)

Immunosuppressants: Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (نشرة أولميسارتان وأملوديبين وهيدروكلوروثيازيد، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

• Interaction with Methotrexate : Concomitant use with PPIs may elevate and/or prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity. (نشرة أوميبرازول، التحذيرات والاحتياطات)

Interaction with Methotrexate : Concomitant use with PPIs may elevate and/or prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity. (نشرة أوميبرازول وبيكربونات الصوديوم، التحذيرات والاحتياطات)

In a crossover trial in 76 pediatric patients, intravenous ondansetron did not increase blood levels of high-dose methotrexate. (نشرة أوندانسيترون، التداخلات الدوائية)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (نشرة إيترافيرين، التداخلات الدوائية)

Monitor patients receiving XATMEP with other potential hepatotoxins (e.g., azathioprine, retinoids, and sulfasalazine) for possible signs of hepatotoxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

• Interaction with Methotrexate : Concomitant use with PPIs may elevate and/or prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity. (نشرة إيزوميبرازول، التحذيرات والاحتياطات)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (نشرة إيفافيرينز، التداخلات الدوائية)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (نشرة إيفافيرينز ولاميفودين وتينوفوفير، التداخلات الدوائية)

Gleevec may delay the clearance of methotrexate when methotrexate is used at high doses (> 500 mg/m 2 ). (نشرة إيماتينيب، التداخلات الدوائية)

Caution should be used when NSAIDs and salicylates are administered concomitantly with lower doses of methotrexate, including XATMEP. (نشرة ميثوتريكسات، التداخلات الدوائية)

Concomitant Use of PROTONIX I.V. with Methotrexate Literature suggests that concomitant use of PPIs with methotrexate (primarily at high dose; see methotrexate prescribing information) may elevate and prolong serum levels of methotrexate and/or its metabolite, possibly leading to methotrexate toxicities. (نشرة بانتوبرازول، التحذيرات والاحتياطات)

Probenecid Probenecid may reduce renal elimination of methotrexate. (نشرة ميثوتريكسات، التداخلات الدوائية)

Probenecid Probenecid may reduce renal elimination of methotrexate. (نشرة ميثوتريكسات، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

Effect of XATMEP on Other Drugs Theophylline Methotrexate may decrease the clearance of theophylline. (نشرة ميثوتريكسات، التداخلات الدوائية)

Effect of Other Drugs on XATMEP Oral Antibiotics Penicillins may reduce the renal clearance of methotrexate; increased serum concentrations of methotrexate with concomitant hematologic and gastrointestinal toxicity have been observed with methotrexate. (نشرة ميثوتريكسات، التداخلات الدوائية)

Effect of Other Drugs on XATMEP Oral Antibiotics Penicillins may reduce the renal clearance of methotrexate; increased serum concentrations of methotrexate with concomitant hematologic and gastrointestinal toxicity have been observed with methotrexate. (نشرة ميثوتريكسات، التداخلات الدوائية)

Treatment has consisted of high doses of corticosteroids alone or, in some cases, concomitantly with an immunosuppressant. (نشرة بنسيلامين، التحذيرات)

Effect of XATMEP on Other Drugs Theophylline Methotrexate may decrease the clearance of theophylline. (نشرة ميثوتريكسات، التداخلات الدوائية)

Effect of XATMEP on Other Drugs Theophylline Methotrexate may decrease the clearance of theophylline. (نشرة ميثوتريكسات، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

Effect of Other Drugs on XATMEP Oral Antibiotics Penicillins may reduce the renal clearance of methotrexate; increased serum concentrations of methotrexate with concomitant hematologic and gastrointestinal toxicity have been observed with methotrexate. (نشرة ميثوتريكسات، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

However, the concomitant use of other antifolic drugs or agents associated with myelosuppression including sulfonamides or trimethoprim- sulfamethoxazole combinations, proguanil, zidovudine, or cytostatic agents (e.g., methotrexate), while the patient is receiving pyrimethamine, may increase the risk of bone marrow suppression. (نشرة بيريميثامين، التداخلات الدوائية)

Monitor patients receiving XATMEP with other potential hepatotoxins (e.g., azathioprine, retinoids, and sulfasalazine) for possible signs of hepatotoxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

Antineoplastic agents (e.g., cyclophosphamide, methotrexate) : Concomitant use of thiazide diuretics may reduce renal excretion of cytotoxic agents and enhance their myelosuppressive effects. (نشرة بينازيبريل وهيدروكلوروثيازيد، التداخلات الدوائية)

Consider discontinuation or reduction of any concomitant chemotherapy or immunosuppressive therapy in patients who develop PML. (نشرة بينداموستين، التحذيرات والاحتياطات)

Caution should be used when NSAIDs and salicylates are administered concomitantly with lower doses of methotrexate, including XATMEP. (نشرة ميثوتريكسات، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

Monitor patients receiving XATMEP with other potential hepatotoxins (e.g., azathioprine, retinoids, and sulfasalazine) for possible signs of hepatotoxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

Trimethoprim/sulfamethoxazole has been reported to increase bone marrow suppression in patients receiving methotrexate. (نشرة ميثوتريكسات، التداخلات الدوائية)

In patients taking AUBAGIO, exposure of drugs which are OAT3 substrates (e.g., cefaclor, cimetidine, ciprofloxacin, penicillin G, ketoprofen, furosemide, methotrexate, zidovudine) may be increased. (نشرة تيريفلونوميد، التداخلات الدوائية)

Immunosuppressants: Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (نشرة تيلميسارتان وأملوديبين، التداخلات الدوائية)

Prophylaxis of PJP should be considered when concomitant use of corticosteroids or other immunosuppressive agents are required. (نشرة تيمسيروليموس، التحذيرات والاحتياطات)

Cyclosporine, tacrolimus: Monitor for toxicities of these immunosuppressive drugs ( 7.1 ) (نشرة تينيدازول، التداخلات الدوائية)

Effect of XATMEP on Other Drugs Theophylline Methotrexate may decrease the clearance of theophylline. (نشرة ميثوتريكسات، التداخلات الدوائية)

Nitrous Oxide The use of nitrous oxide anesthesia potentiates the effect of methotrexate on folate-dependent metabolic pathways, resulting in the potential for increase toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

Frequent PT/INR determinations are advisable until it has been definitely determined that the PT/INR has stabilized Immunosuppressants Clinical Impact: Immunosuppressants such as cyclosporine and tacrolimus can produce nephrotoxicity with decreases in creatinine clearance and rises in serum creatinine, and because renal excretion is the primary elimination route… (نشرة حمض الفينوفيبريك، التداخلات الدوائية)

Therapeutic drug monitoring is recommended with concomitant use Immunosuppressant /neoplastic: everolimus ↑ immunosuppressants Co-administration of everolimus and PREZCOBIX or PREZCOBIX PED is not recommended. irinotecan Discontinue PREZCOBIX or PREZCOBIX PED at least 1 week prior to starting irinotecan therapy. (نشرة دارونافير وكوبيسيستات، التداخلات الدوائية)

Hepatotoxic medications, such as high-dose methotrexate, may impair liver function and increase the risk of toxicity. (نشرة داونوروبيسين، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

Aspirin, carbapenem antibiotics, estrogen-containing hormonal contraceptives, methotrexate: Monitoring of valproate concentrations is recommended ( 7.1 ) (نشرة ديفالبروكس (فالبروات)، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

Interaction with Methotrexate : Concomitant use with PPIs may elevate and/or prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity. (نشرة ديكسلانسوبرازول، التحذيرات والاحتياطات)

Effect of Other Drugs on XATMEP Oral Antibiotics Penicillins may reduce the renal clearance of methotrexate; increased serum concentrations of methotrexate with concomitant hematologic and gastrointestinal toxicity have been observed with methotrexate. (نشرة ميثوتريكسات، التداخلات الدوائية)

Other risk factors for the development of ONJ include immunosuppressive therapy, treatment with angiogenesis inhibitors, systemic corticosteroids, diabetes, and gingival infections. (نشرة دينوسوماب، التحذيرات والاحتياطات)

Interaction with Methotrexate : Concomitant use with PPIs may elevate and/or prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity. (نشرة رابيبرازول، التحذيرات والاحتياطات)

BCRP Substrates with a Narrow Therapeutic Index (e.g., methotrexate, topotecan, or irinotecan) Clinical Impact: Increased plasma concentrations of BCRP substrates (e.g., methotrexate, topotecan, or irinotecan) may result in potential adverse reactions [see Clinical Pharmacology (12.3) ]. (نشرة رولابيتانت، التداخلات الدوائية)

Immunosuppressants: cyclosporine, tacrolimus, sirolimus (rapamycin) ↑ immunosuppressants Therapeutic concentration monitoring is recommended for immunosuppressant agents when co-administered with ritonavir. (نشرة ريتونافير، التداخلات الدوائية)

…Digoxin Corticosteroids Prednisone Fibrates Clofibrate Oral Hypoglycemics Sulfonylureas (e.g., glyburide, glipizide) Hormonal Contraceptives/Progestins Ethinyl estradiol, levonorgestrel Immunosuppressants Cyclosporine, tacrolimus Methylxanthines Theophylline Narcotic analgesics Methadone Phosphodiesterase-5 (PDE-5) Inhibitors Sildenafil Thyroid preparations Levothyroxine… (نشرة ريفابنتين، التداخلات الدوائية)

Glipizide Decrease exposure Immunosuppressive Agents Cyclosporine Decrease exposure Tacrolimus Prevention or Management: Monitoring of whole blood concentrations and appropriate dosage adjustments of tacrolimus are recommended when rifampin and tacrolimus are used concomitantly. (نشرة ريفامبيسين، التداخلات الدوائية)

Inhibitors of Folate Synthesis (e.g., methotrexate, valproic acid, phenobarbital, trimethoprim) Clinical Impact In vitro and in vivo nonclinical data suggest that drugs that inhibit folate synthesis may decrease the bioavailability of endogenous BH4 by inhibiting the enzyme dihydrofolate reductase, which is involved in the recycling (regeneration) of BH4. (نشرة سابروبترين، التداخلات الدوائية)

Drug Interactions Administration of a sulfonamide may increase the effect of oral anticoagulants and methotrexate, probably by displacement of these drugs from binding sites on plasma albumin. (نشرة سلفاديازين، التداخلات الدوائية)

Monitor patients receiving XATMEP with other potential hepatotoxins (e.g., azathioprine, retinoids, and sulfasalazine) for possible signs of hepatotoxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

Trimethoprim/sulfamethoxazole has been reported to increase bone marrow suppression in patients receiving methotrexate. (نشرة ميثوتريكسات، التداخلات الدوائية)

Methotrexate Use with caution Inhibition of methotrexate renal tubular transport potentially leading to increased methotrexate plasma levels Potential increase in the risk of methotrexate associated toxic reactions. (نشرة سيبروفلوكساسين، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

Methotrexate and other drugs undergoing renal tubular secretion Furosemide may decrease renal elimination of other drugs that undergo tubular secretion. (نشرة فوروسيميد، التداخلات الدوائية)

In addition, voriconazole has been associated with photosensitivity related skin reactions such as pseudoporphyria, cheilitis, and cutaneous lupus erythematosus, as well as increased risk of skin toxicity with concomitant use of methotrexate, a drug associated with ultraviolet (UV) reactivation. (نشرة فوريكونازول، التحذيرات والاحتياطات)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus ↑ Immunosuppressants Therapeutic concentration monitoring is recommended for immunosuppressant agents. (نشرة فوسامبرينافير، التداخلات الدوائية)

…ticlopidine, tolbutamide, trazodone, warfarin Drugs that may decrease phenytoin serum levels Antineoplastic agents usually in combination Bleomycin, carboplatin, cisplatin, doxorubicin, methotrexate Antiviral agents Fosamprenavir, nelfinavir, ritonavir Antiepileptic drugs Carbamazepine, vigabatrin Other Chronic alcohol abuse, diazepam, diazoxide, folic acid, reserpine,… (نشرة فوسفينيتوين، التداخلات الدوائية)

Effect of XATMEP on Other Drugs Theophylline Methotrexate may decrease the clearance of theophylline. (نشرة ميثوتريكسات، التداخلات الدوائية)

Immunosuppressants Clinical Impact: Immunosuppressants such as cyclosporine and tacrolimus can produce nephrotoxicity with decreases in creatinine clearance and rises in serum creatinine, and because renal excretion is the primary elimination route of fibrate drugs including fenofibrate, there is a risk that an interaction will lead to deterioration of renal… (نشرة فينوفيبرات، التداخلات الدوائية)

Closely monitor for signs of renal toxicity when XELODA is used concomitantly with nephrotoxic drugs (e.g. platinum salts, irinotecan, methotrexate, intravenous bisphosphonates). (نشرة كابيسيتابين، التداخلات الدوائية)

Cytotoxic products – Thiazides may reduce the renal excretion of cytotoxic medicinal products (e.g. cyclophosphamide, methotrexate) and potentiate their myelosuppressive effects. (نشرة كانديسارتان وهيدروكلوروثيازيد، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

Immunosuppressants everolimus, rapamycin (also known as sirolimus), temsirolimus budesonide, ciclesonide, cyclosporine, dexamethasone, fluticasone, methylprednisolone, tacrolimus Rapamycin (sirolimus): Ketoconazole tablets 200 mg daily for 10 days increased the C max and AUC of a single 5 mg dose of sirolimus by 4.3 fold and 10.9 fold, respectively in 23 healthy… (نشرة كيتوكونازول، التداخلات الدوائية)

Interaction with Methotrexate : Concomitant use with PPIs may elevate and/or prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity. (نشرة لانسوبرازول، التحذيرات والاحتياطات)

Immunosuppressants: e.g. cyclosporine, tacrolimus, sirolimus ↑ immunosuppressants Therapeutic concentration monitoring is recommended for immunosuppressant agents when co-administered with KALETRA. (نشرة لوبينافير وريتونافير، التداخلات الدوائية)

Caution should be exercised when JUXTAPID is used with other medications known to have potential for hepatotoxicity, such as isotretinoin, amiodarone, acetaminophen (>4 g/day for ≥3 days/week), methotrexate, tetracyclines, and tamoxifen. (نشرة لوميتابيد، التحذيرات والاحتياطات)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (نشرة ليديباسفير وسوفوسبوفير، التحذيرات والاحتياطات)

If ARAVA and methotrexate are given concomitantly, follow the American College of Rheumatology (ACR) guidelines for monitoring methotrexate liver toxicity with ALT, AST, and serum albumin testing. (نشرة ليفلونوميد، التحذيرات والاحتياطات)

Caution should be used when NSAIDs and salicylates are administered concomitantly with lower doses of methotrexate, including XATMEP. (نشرة ميثوتريكسات، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

A treatment regimen containing multiple immunosuppressants (including thiopurines) should therefore be used with caution as this could lead to lymphoproliferative disorders, some with reported fatalities. (نشرة ميركابتوبورين، التحذيرات والاحتياطات)

Caution should be used when NSAIDs and salicylates are administered concomitantly with lower doses of methotrexate, including XATMEP. (نشرة ميثوتريكسات، التداخلات الدوائية)

Lymphoma and Other Malignancies Patients receiving immunosuppressants, including mycophenolate mofetil, are at increased risk of developing lymphomas and other malignancies, particularly of the skin [see Adverse Reactions ( 6.1 )]. (نشرة ميكوفينولات، التحذيرات والاحتياطات)

…infections, Crohn’s disease patients receiving natalizumab products should not be treated with concomitant immunosuppressants (e.g., 6‑ mercaptopurine, azathioprine, cyclosporine, or methotrexate) or inhibitors of TNF-α, and corticosteroids should be tapered in those patients with Crohn’s disease who are on chronic corticosteroids when they start TYRUKO therapy… (نشرة ناتاليزوماب، التداخلات الدوائية)

Effect of Other Drugs on XATMEP Oral Antibiotics Penicillins may reduce the renal clearance of methotrexate; increased serum concentrations of methotrexate with concomitant hematologic and gastrointestinal toxicity have been observed with methotrexate. (نشرة ميثوتريكسات، التداخلات الدوائية)

OAT1/OAT3 Substrates (e.g., adefovir, ganciclovir, methotrexate) Clinical Impact Increased exposure of the interacting drug. [see Clinical Pharmacology ( 12.3 )] Prevention or Management Monitor for potential adverse reactions related to the co-administered drug. (نشرة نيتيسينون، التداخلات الدوائية)

Immunosuppressive Agents There have been reports of increased blood concentrations of cyclosporine and tacrolimus into toxic ranges when patients received these drugs concomitantly with nefazodone. (نشرة نيفازودون، التداخلات الدوائية)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus Plasma concentrations may be decreased. (نشرة نيفيرابين، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

Methotrexate Concomitant use of PLAQUENIL and methotrexate may increase the incidence of adverse reactions. (نشرة هيدروكسي كلوروكين، التداخلات الدوائية)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (نشرة ميثوتريكسات، التداخلات الدوائية)

IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persists despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (نشرة أتورفاستاتين، التحذيرات والاحتياطات)

Thirty-four patients were treated with corticosteroids and one patient was treated with a non-steroidal immunosuppressant. (نشرة أكسيتينيب، التحذيرات والاحتياطات)

IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy without significant inflammation; and improvement with immunosuppressive agents. (نشرة إيزيتيميب وسيمفاستاتين، التحذيرات والاحتياطات)

Administer prophylaxis for PJP when concomitant use of corticosteroids or other immunosuppressive agents are required. (نشرة إيفيروليموس، التحذيرات والاحتياطات)

IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (نشرة برافاستاتين، التحذيرات والاحتياطات)

In some cases, vasculitis resolved/improved with drug discontinuation; however, more severe cases required treatment with additional measures including corticosteroids, immunosuppressant therapy, and plasmapheresis. (نشرة بروبيل ثيوراسيل، التحذيرات)

CYP3A Substrates Immunosuppressants that are CYP3A4 Substrates Mechanism and Clinical Effect(s) Posaconazole is a strong CYP3A4 inhibitor. (نشرة بوساكونازول، التداخلات الدوائية)

IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (نشرة بيتافاستاتين، التحذيرات والاحتياطات)

…performed, the following concomitant drugs were used in at least 10% of patients in either or both Sjogren's efficacy studies: acetylsalicylic acid, artificial tears, calcium, conjugated estrogens, hydroxychloroquine sulfate, ibuprofen, levothyroxine sodium, medroxyprogesterone acetate, methotrexate, multivitamins, naproxen, omeprazole, paracetamol, and prednisone. (نشرة بيلوكاربين، التداخلات الدوائية)

IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (نشرة روسوفاستاتين، التحذيرات والاحتياطات)

The effect of rituximab on immune responses was assessed in a randomized, controlled study in patients with RA treated with rituximab and methotrexate (MTX) compared to patients treated with MTX alone. (نشرة ريتوكسيماب، التحذيرات والاحتياطات)

…Probenecid Probenecid is known to interact with the metabolism or renal tubular excretion of many drugs (e.g., acetaminophen, acyclovir, angiotensin-converting enzyme inhibitors, aminosalicylic acid, barbiturates, benzodiazepines, bumetanide, clofibrate, methotrexate, famotidine, furosemide, nonsteroidal anti-inflammatory agents, theophylline, and zidovudine). (نشرة سيدوفوفير، التداخلات الدوائية)

IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy without significant inflammation; and improvement with immunosuppressive agents. (نشرة سيمفاستاتين، التحذيرات والاحتياطات)

IMNM is characterized by proximal muscle weakness and elevated serum CK, which persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody, muscle biopsy showing necrotizing myopathy, and improvement with immunosuppressive agents. (نشرة فلوفاستاتين، التحذيرات والاحتياطات)

IMNM is characterized by: proximal muscle weakness and elevated serum creatine kinase, which persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (نشرة لوفاستاتين، التحذيرات)

In some cases, vasculitis resolved/improved with drug discontinuation; however, more severe cases required treatment with additional measures including corticosteroids, immunosuppressant therapy, and plasmapheresis. (نشرة ميثيمازول، التحذيرات)

Immunosuppressive Drugs Tacrolimus: Tacrolimus has been shown to be metabolized via the CYP3A system. (نشرة نيفيديبين، الاحتياطات)

Oral neomycin inhibits the gastrointestinal absorption of penicillin V, oral vitamin B-12, methotrexate and 5-fluorouracil. (نشرة نيومايسين، التداخلات الدوائية)

…Repaglinide, Rosiglitazone: [See Warnings and Precautions ( 5.4 ) and Adverse Reactions ( 6.2 )] Insulin Insulin: [See Warnings and Precautions ( 5.4 ) and Adverse Reactions ( 6.2 )] Immunosuppressants: Cyclosporine Use With Caution Cyclosporine: There have been spontaneous or published reports of CYP3A based interactions of clarithromycin with cyclosporine. (نشرة كلاريثرومايسين، التداخلات الدوائية)