Liverpool HEP Interactions

Potential Interaction

Adefovir

Favipiravir

Summary:

Coadministration has not been studied. Favipiravir is mainly metabolised by aldehyde oxidase and undergoes no CYP-mediated metabolism. Favipiravir is a moderate inhibitor of OAT1. Adefovir is eliminated renally via glomerular filtration and active renal secretion by OAT1. Inhibition of this renal transporter could impair adefovir renal elimination. Monitor renal function when coadministering these drugs.

Description:

(See Summary)

No Interaction Expected

Adefovir

Dienogest

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dienogest is a substrate of CYP3A4. The potential for hepatically metabolised interactions with adefovir is low. Adefovir is eliminated renally via glomerular filtration and active renal secretion by OAT1.

Description:

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No Interaction Expected

Adefovir

Doxycycline

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Doxycycline is excreted in the urine and faeces as unchanged active substance. Between 40-60% of an administered dose can be accounted for in the urine. Studies have indicated that administration of doxycycline at the usual recommended doses does not lead to excessive accumulation in patients with renal impairment. Adefovir is eliminated renally via glomerular filtration and active renal secretion by OAT1. There is little potential for a clinically significant interaction with adefovir via completion for renal elimination transport mechanisms.

Description:

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No Interaction Expected

Adefovir

Ecstasy (MDMA)

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. MDMA is metabolized mainly by CYP2D6. The potential for hepatically metabolised interactions with adefovir is low. Adefovir is eliminated renally via glomerular filtration and active renal secretion by OAT1.

Description:

(See Summary)

No Interaction Expected

Adefovir

Fingolimod

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fingolimod is metabolised mainly by CYP4F2 and is unlikely to interact with substrates of CYP enzymes or the main transporter proteins. The potential for hepatically metabolised interactions with adefovir is low. Adefovir is eliminated renally via glomerular filtration and active renal secretion by OAT1.

Description:

(See Summary)

No Interaction Expected

Adefovir

Ketamine

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Ketamine is mainly metabolized by CYP3A4 and to a lesser extent by CYP2B6 and CYP2C9 in the range of concentrations used in anaesthesia. The potential for hepatically metabolised interactions with adefovir is low. Adefovir is eliminated renally via glomerular filtration and active renal secretion by OAT1.

Description:

(See Summary)

No Interaction Expected

Adefovir

Lamotrigine

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lamotrigine is mainly glucuronidated by UGT1A4. The potential for hepatically metabolised interactions with adefovir is low. Adefovir is eliminated renally via glomerular filtration and active renal secretion by OAT1.

Description:

(See Summary)

No Interaction Expected

Adefovir

Nifedipine

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nifedipine is metabolised mainly by CYP3A4. The potential for hepatically metabolised interactions with adefovir is low. Adefovir is eliminated renally via glomerular filtration and active renal secretion by OAT1.

Description:

(See Summary)

No Interaction Expected

Adefovir

Rivaroxaban

Summary:

Coadministration has not been studied, but based on metabolism and clearance a clinically significant interaction is unlikely as rivaroxaban undergoes primarily metabolic degradation. Adefovir is eliminated renally via glomerular filtration and active renal secretion by OAT1.

Description:

(See Summary)

No Interaction Expected

Adefovir

Tacrolimus

Summary:

No pharmacokinetic interaction was observed when adefovir (10 mg once daily) and tacrolimus were administered to liver transplant patients. Adefovir and tacrolimus can be coadministered with routine therapeutic drug monitoring of tacrolimus as concentrations may alter as a result of improved liver function.

Description:

A clinical study in liver-transplant patients has shown that no pharmacokinetic interaction occurs when adefovir dipivoxil 10 mg once daily is administered concomitantly with tacrolimus, an immunosuppressant which is predominantly metabolised via the CYP450 system. Nevertheless, given that tacrolimus can affect renal function, close monitoring is recommended when coadministered with adefovir dipivoxil. The renal function of these patients should be closely monitored with a frequency tailored to the individual patient's medical condition.

Hepsera Summary of Product Characteristics, Gilead Sciences Ltd, May 2018.

The pharmacokinetics of adefovir have been evaluated in post-liver transplantation patients following multiple dose administration of Hepsera (10 mg once daily) in combination with tacrolimus (N=16). Adefovir did not alter the pharmacokinetics of tacrolimus. The pharmacokinetics of adefovir were unchanged when Hepsera was coadministered with tacrolimus (based on cross study comparison). Chronic administration of Hepsera (10 mg once daily) may result in delayed nephrotoxicity. The overall risk of nephrotoxicity in patients with adequate renal function is low. However, this is of special importance in patients at risk of or having underlying renal dysfunction and patients taking concomitant nephrotoxic agents such as tacrolimus. It is recommended that creatinine clearance is calculated in all patients prior to initiating therapy with Hepsera.

Hepsera US Prescribing Information, Gilead Sciences Inc, December 2018.

Non-HBV-infected post-transplant recipients (n=16) with stable hepatic and renal function on a stable daily dose of tacrolimus (2-10 mg total daily dose) were studied before and after co-administration of adefovir 10 mg daily for 14 days. The AUC, Cmax and median elimination half-life of tacrolimus were not significantly altered by co-administration of adefovir. Adefovir PK parameters were comparable to historical data in non-transplant patients receiving adefovir alone. Serum creatinine values were stable during the study period.

Pharmacokinetics of tacrolimus co-administered with adefovir dipivoxil to liver transplant recipients Terrault N, Tran T, Schiff E et al. Liver Int. 2009; 29: 1178-83.

No Interaction Expected

Adefovir

Inula racemosa

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alantolactone, a component of Inula racemosa, moderately inhibits CYP3A4 in vitro, however, the potential for hepatically metabolised interactions with adefovir is low. Adefovir is eliminated renally via glomerular filtration and active renal secretion by OAT1.

Description:

(See Summary)

No Interaction Expected

Adefovir

Apixaban

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Apixaban is metabolized by CYP3A4 and to a lesser extent by CYP1A2, CYP2C8, CYP2C9 and CYP2C19. The potential for hepatically metabolised interactions with adefovir is low. Adefovir is eliminated renally via glomerular filtration and active renal secretion by OAT1.

Description:

(See Summary)

No Interaction Expected

Adefovir

Molly (Ecstasy, MDMA)

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. MDMA is metabolized mainly by CYP2D6. The potential for hepatically metabolised interactions with adefovir is low. Adefovir is eliminated renally via glomerular filtration and active renal secretion by OAT1.

Description:

(See Summary)

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