Wechselwirkungen von Methotrexat

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

An increased risk of hepatitis has been reported to result from combined use of methotrexate and etretinate. (Fachinformation zu Acitretin, Gegenanzeigen)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Fachinformation zu Adalimumab, Boxed Warning (umrahmter Warnhinweis))

Most patients with rheumatoid arthritis who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Fachinformation zu Baricitinib, Boxed Warning (umrahmter Warnhinweis))

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Captopril, Warnhinweise)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

In kidney, liver, and heart transplant patients Neoral may be administered with other immunosuppressive agents. (Fachinformation zu Ciclosporin, Boxed Warning (umrahmter Warnhinweis))

Prevention or Management Concomitant use with myelosuppressive or other immunosuppressive drugs is not recommended. (Fachinformation zu Cladribin, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Darunavir, Arzneimittelwechselwirkungen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

Use of KEVEYIS with drugs that are sensitive to OAT1 inhibition (e.g., methotrexate, famotidine, oseltamivir) is not recommended [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Diclofenamid, Arzneimittelwechselwirkungen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Fachinformation zu Etanercept, Boxed Warning (umrahmter Warnhinweis))

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

Chicken pox and measles, for example, can have a more serious or even fatal course in children on immunosuppressant corticosteroids. (Fachinformation zu Fludrocortison, Warnhinweise)

Persons who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chickenpox or measles. (Fachinformation zu Flunisolid, Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Foscarnet, Arzneimittelwechselwirkungen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Fachinformation zu Infliximab, Boxed Warning (umrahmter Warnhinweis))

Immunosuppressants Everolimus Sirolimus Temsirolimus (IV) Not recommended during and 2 weeks after TOLSURA treatment. (Fachinformation zu Itraconazol, Arzneimittelwechselwirkungen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

…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:… (Fachinformation zu Nirmatrelvir und Ritonavir, Gegenanzeigen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

…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,… (Fachinformation zu Phenytoin, Arzneimittelwechselwirkungen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

Dihydrofolate Reductase (DHFR) Inhibitors : Avoid concomitant use (e.g., trimethoprim, methotrexate, trimetrexate, pemetrexed, pralatrexate, raltitrexed, or piritrexim). (Fachinformation zu Sepiapterin, Arzneimittelwechselwirkungen)

Coadministration of VOSEVI with BCRP substrates (e.g., methotrexate, mitoxantrone, imatinib, irinotecan, lapatinib, rosuvastatin, sulfasalazine, topotecan) is not recommended [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Sofosbuvir und Velpatasvir, Arzneimittelwechselwirkungen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

…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. (Fachinformation zu Tacrolimus, Boxed Warning (umrahmter Warnhinweis))

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Fachinformation zu Tocilizumab, Boxed Warning (umrahmter Warnhinweis))

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Fachinformation zu Tofacitinib, Boxed Warning (umrahmter Warnhinweis))

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 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Fachinformation zu Upadacitinib, Boxed Warning (umrahmter Warnhinweis))

Monitor patients receiving XATMEP with other potential hepatotoxins (e.g., azathioprine, retinoids, and sulfasalazine) for possible signs of hepatotoxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Effect of XATMEP on Other Drugs Theophylline Methotrexate may decrease the clearance of theophylline. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Effect of XATMEP on Other Drugs Theophylline Methotrexate may decrease the clearance of theophylline. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Fachinformation zu Amlodipin, Arzneimittelwechselwirkungen)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Fachinformation zu Amlodipin und Atorvastatin, Arzneimittelwechselwirkungen)

Immunosuppressants: Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Fachinformation zu Amlodipin und Olmesartan, Arzneimittelwechselwirkungen)

Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when coadministered. (Fachinformation zu Amlodipin und Valsartan, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Immunosuppressants: cyclosporine, sirolimus, tacrolimus ↑ immunosuppressants Therapeutic concentration monitoring is recommended for these immunosuppressants when coadministered with REYATAZ. (Fachinformation zu Atazanavir, Arzneimittelwechselwirkungen)

Monitor patients receiving XATMEP with other potential hepatotoxins (e.g., azathioprine, retinoids, and sulfasalazine) for possible signs of hepatotoxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Caution should be used when NSAIDs and salicylates are administered concomitantly with lower doses of methotrexate, including XATMEP. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Antineoplastic agents (e.g., cyclophosphamide, methotrexate) : Concomitant use of thiazide diuretics may reduce renal excretion of cytotoxic agents and enhance their myelosuppressive effects. (Fachinformation zu Benazepril und Hydrochlorothiazid, Arzneimittelwechselwirkungen)

Consider discontinuation or reduction of any concomitant chemotherapy or immunosuppressive therapy in patients who develop PML. (Fachinformation zu Bendamustin, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Monitor patients receiving XATMEP with other potential hepatotoxins (e.g., azathioprine, retinoids, and sulfasalazine) for possible signs of hepatotoxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Caution should be used when NSAIDs and salicylates are administered concomitantly with lower doses of methotrexate, including XATMEP. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Effect of XATMEP on Other Drugs Theophylline Methotrexate may decrease the clearance of theophylline. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Effect of XATMEP on Other Drugs Theophylline Methotrexate may decrease the clearance of theophylline. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Cytotoxic products – Thiazides may reduce the renal excretion of cytotoxic medicinal products (e.g. cyclophosphamide, methotrexate) and potentiate their myelosuppressive effects. (Fachinformation zu Candesartan und Hydrochlorothiazid, Arzneimittelwechselwirkungen)

Closely monitor for signs of renal toxicity when XELODA is used concomitantly with nephrotoxic drugs (e.g. platinum salts, irinotecan, methotrexate, intravenous bisphosphonates). (Fachinformation zu Capecitabin, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Ciprofloxacin, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Darunavir und Cobicistat, Arzneimittelwechselwirkungen)

Hepatotoxic medications, such as high-dose methotrexate, may impair liver function and increase the risk of toxicity. (Fachinformation zu Daunorubicin, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Other risk factors for the development of ONJ include immunosuppressive therapy, treatment with angiogenesis inhibitors, systemic corticosteroids, diabetes, and gingival infections. (Fachinformation zu Denosumab, Warnhinweise und Vorsichtsmaßnahmen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Interaction with Methotrexate : Concomitant use with PPIs may elevate and/or prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity. (Fachinformation zu Dexlansoprazol, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

…(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). (Fachinformation zu Eltrombopag, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Elvitegravir, Cobicistat, Emtricitabin und Tenofovir, Arzneimittelwechselwirkungen)

Effect of XATMEP on Other Drugs Theophylline Methotrexate may decrease the clearance of theophylline. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

• Interaction with Methotrexate : Concomitant use with PPIs may elevate and/or prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity. (Fachinformation zu Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Etravirin, Arzneimittelwechselwirkungen)

Effect of XATMEP on Other Drugs Theophylline Methotrexate may decrease the clearance of theophylline. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

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… (Fachinformation zu Fenofibrat, Arzneimittelwechselwirkungen)

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… (Fachinformation zu Fenofibrinsäure, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus ↑ Immunosuppressants Therapeutic concentration monitoring is recommended for immunosuppressant agents. (Fachinformation zu Fosamprenavir, Arzneimittelwechselwirkungen)

…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,… (Fachinformation zu Fosphenytoin, Arzneimittelwechselwirkungen)

Methotrexate and other drugs undergoing renal tubular secretion Furosemide may decrease renal elimination of other drugs that undergo tubular secretion. (Fachinformation zu Furosemid, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Methotrexate Concomitant use of PLAQUENIL and methotrexate may increase the incidence of adverse reactions. (Fachinformation zu Hydroxychloroquin, Arzneimittelwechselwirkungen)

Gleevec may delay the clearance of methotrexate when methotrexate is used at high doses (> 500 mg/m 2 ). (Fachinformation zu Imatinib, Arzneimittelwechselwirkungen)

Monitor patients receiving XATMEP with other potential hepatotoxins (e.g., azathioprine, retinoids, and sulfasalazine) for possible signs of hepatotoxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

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… (Fachinformation zu Ketoconazol, Arzneimittelwechselwirkungen)

Interaction with Methotrexate : Concomitant use with PPIs may elevate and/or prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity. (Fachinformation zu Lansoprazol, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Leflunomid, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Lomitapid, Warnhinweise und Vorsichtsmaßnahmen)

Immunosuppressants: e.g. cyclosporine, tacrolimus, sirolimus ↑ immunosuppressants Therapeutic concentration monitoring is recommended for immunosuppressant agents when co-administered with KALETRA. (Fachinformation zu Lopinavir und Ritonavir, Arzneimittelwechselwirkungen)

Caution should be used when NSAIDs and salicylates are administered concomitantly with lower doses of methotrexate, including XATMEP. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Mercaptopurin, Warnhinweise und Vorsichtsmaßnahmen)

Caution should be used when NSAIDs and salicylates are administered concomitantly with lower doses of methotrexate, including XATMEP. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

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 )]. (Fachinformation zu Mycophenolat, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

…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… (Fachinformation zu Natalizumab, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Nefazodon, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus Plasma concentrations may be decreased. (Fachinformation zu Nevirapin, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Nitisinon, Arzneimittelwechselwirkungen)

Immunosuppressants: Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Fachinformation zu Olmesartan, Amlodipin und Hydrochlorothiazid, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

• Interaction with Methotrexate : Concomitant use with PPIs may elevate and/or prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity. (Fachinformation zu Omeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Interaction with Methotrexate : Concomitant use with PPIs may elevate and/or prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity. (Fachinformation zu Omeprazol und Natriumhydrogencarbonat, Warnhinweise und Vorsichtsmaßnahmen)

In a crossover trial in 76 pediatric patients, intravenous ondansetron did not increase blood levels of high-dose methotrexate. (Fachinformation zu Ondansetron, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Pantoprazol, Warnhinweise und Vorsichtsmaßnahmen)

Treatment has consisted of high doses of corticosteroids alone or, in some cases, concomitantly with an immunosuppressant. (Fachinformation zu Penicillamin, Warnhinweise)

Effect of XATMEP on Other Drugs Theophylline Methotrexate may decrease the clearance of theophylline. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Probenecid Probenecid may reduce renal elimination of methotrexate. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Probenecid Probenecid may reduce renal elimination of methotrexate. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Pyrimethamin, Arzneimittelwechselwirkungen)

Interaction with Methotrexate : Concomitant use with PPIs may elevate and/or prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity. (Fachinformation zu Rabeprazol, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Rifampicin, Arzneimittelwechselwirkungen)

…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… (Fachinformation zu Rifapentin, Arzneimittelwechselwirkungen)

Immunosuppressants: cyclosporine, tacrolimus, sirolimus (rapamycin) ↑ immunosuppressants Therapeutic concentration monitoring is recommended for immunosuppressant agents when co-administered with ritonavir. (Fachinformation zu Ritonavir, Arzneimittelwechselwirkungen)

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) ]. (Fachinformation zu Rolapitant, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Sapropterin, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Sulfadiazin, Arzneimittelwechselwirkungen)

Trimethoprim/sulfamethoxazole has been reported to increase bone marrow suppression in patients receiving methotrexate. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Monitor patients receiving XATMEP with other potential hepatotoxins (e.g., azathioprine, retinoids, and sulfasalazine) for possible signs of hepatotoxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Immunosuppressants: Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Fachinformation zu Telmisartan und Amlodipin, Arzneimittelwechselwirkungen)

Prophylaxis of PJP should be considered when concomitant use of corticosteroids or other immunosuppressive agents are required. (Fachinformation zu Temsirolimus, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Teriflunomid, Arzneimittelwechselwirkungen)

Effect of XATMEP on Other Drugs Theophylline Methotrexate may decrease the clearance of theophylline. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Cyclosporine, tacrolimus: Monitor for toxicities of these immunosuppressive drugs ( 7.1 ) (Fachinformation zu Tinidazol, Arzneimittelwechselwirkungen)

Monitor patients receiving XATMEP with other potential hepatotoxins (e.g., azathioprine, retinoids, and sulfasalazine) for possible signs of hepatotoxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Trimethoprim/sulfamethoxazole has been reported to increase bone marrow suppression in patients receiving methotrexate. (Fachinformation zu Methotrexat, Arzneimittelwechselwirkungen)

Aspirin, carbapenem antibiotics, estrogen-containing hormonal contraceptives, methotrexate: Monitoring of valproate concentrations is recommended ( 7.1 ) (Fachinformation zu Valproat-Seminatrium (Divalproex), Arzneimittelwechselwirkungen)

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. (Fachinformation zu Voriconazol, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Atorvastatin, Warnhinweise und Vorsichtsmaßnahmen)

Thirty-four patients were treated with corticosteroids and one patient was treated with a non-steroidal immunosuppressant. (Fachinformation zu Axitinib, Warnhinweise und Vorsichtsmaßnahmen)

…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). (Fachinformation zu Cidofovir, Arzneimittelwechselwirkungen)

Administer prophylaxis for PJP when concomitant use of corticosteroids or other immunosuppressive agents are required. (Fachinformation zu Everolimus, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Ezetimib und Simvastatin, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Fluvastatin, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Lovastatin, Warnhinweise)

Oral neomycin inhibits the gastrointestinal absorption of penicillin V, oral vitamin B-12, methotrexate and 5-fluorouracil. (Fachinformation zu Neomycin, Arzneimittelwechselwirkungen)

Immunosuppressive Drugs Tacrolimus: Tacrolimus has been shown to be metabolized via the CYP3A system. (Fachinformation zu Nifedipin, Vorsichtsmaßnahmen)

…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. (Fachinformation zu Pilocarpin, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Pitavastatin, Warnhinweise und Vorsichtsmaßnahmen)

CYP3A Substrates Immunosuppressants that are CYP3A4 Substrates Mechanism and Clinical Effect(s) Posaconazole is a strong CYP3A4 inhibitor. (Fachinformation zu Posaconazol, Arzneimittelwechselwirkungen)

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. (Fachinformation zu Pravastatin, Warnhinweise und Vorsichtsmaßnahmen)

In some cases, vasculitis resolved/improved with drug discontinuation; however, more severe cases required treatment with additional measures including corticosteroids, immunosuppressant therapy, and plasmapheresis. (Fachinformation zu Propylthiouracil, Warnhinweise)

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. (Fachinformation zu Rituximab, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Rosuvastatin, Warnhinweise und Vorsichtsmaßnahmen)

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. (Fachinformation zu Simvastatin, Warnhinweise und Vorsichtsmaßnahmen)

In some cases, vasculitis resolved/improved with drug discontinuation; however, more severe cases required treatment with additional measures including corticosteroids, immunosuppressant therapy, and plasmapheresis. (Fachinformation zu Thiamazol, Warnhinweise)

…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. (Fachinformation zu Clarithromycin, Arzneimittelwechselwirkungen)