Cymevene Drug Interactions

Imipenem-cilastatin: Convulsions have been reported in patients who received ganciclovir and imipenem-cilastatin and a pharmacodynamic interaction between these two drugs cannot be discounted. These drugs should not be used concomitantly unless the potential benefits outweigh the risks (see General: Use with other medicines under Precautions).
Potential drug interactions: Toxicity may be enhanced when ganciclovir is co-administered with other drugs known to be myelosuppressive or associated with renal impairment. This includes nucleoside analogues (e.g. zidovudine, didanosine, stavudine), immunosuppressants (e.g. ciclosporin, tacrolimus, mycophenolate mofetil), antineoplastic agents (e.g. doxorubicin, vincristine, vinblastine, hydroxyurea), and anti-infectives (e.g. trimethoprim/sulphonamides, dapsone, amphotericin B, flucytosine, pentamidine). Therefore, these drugs should only be considered for concomitant use with ganciclovir if the potential benefits outweigh the potential risks (see General: Use with other medicines under Precautions).
Zidovudine: Both zidovudine and Cymevene have the potential to cause neutropenia and anemia, a pharmacodynamic interaction may occur during concomitant administration of these drugs some patients may not tolerate concomitant therapy at full dosage (see General: Use with other medicines under Precautions).
Didanosine: Didanosine plasma concentrations were found to be consistently raised when given with IV ganciclovir. At intravenous doses of 5 and 10 mg/kg/day, an increase in the AUC of didanosine ranging from 38 to 67% has been observed confirming a pharmacokinetic interaction during the concomitant administration of these drugs. There was no significant effect on ganciclovir concentrations. Patients should be closely monitored for didanosine toxicity (e.g. pancreatitis) (see General: Use with other medicines under Precautions).
Probenecid: Probenecid given with oral ganciclovir resulted in statistically decreased renal clearance of ganciclovir (20%) leading to statistically significant increased exposure (40%). These changes were consistent with a mechanism of interaction involving competition for renal tubular excretion. Therefore patients taking probenecid and Cymevene should be closely monitored for ganciclovir toxicity.