Tonact-FN

Tonact-FN Drug Interactions

Manufacturer:

Lupin (Inventia)

Distributor:

Maxxcare

Marketer:

Lupin
Full Prescribing Info
Drug Interactions
Strong Inhibitors of CYP3A4: Atorvastatin is metabolized by CY3A4. Concomitant administration of atorvastatin with strong inhibitors of CYP3A4  (clarithromycin, combination of protease inhibitors, itraconazole, diltiazem hydrochloride) can lead to increases in plasma concentrations of atorvastatin. The extent of interaction and potentiation of effects depends on the variability of effect on CYP3A4.
Inducers of CYP3A4: Concomitant administration of atorvastatin with inducers of CYP34 (eg efavirenz, rifampin) can lead to variable reductions in plasma concentrations of atorvastatin. Due to the dual interaction mechanism of rifampin, simultaneous co-administration of atorvastatin with rifampin is recommended, as delayed administration of atorvastatin after administration of rifampin has been associated with a significant reduction in atorvastatin plasma concentrations.
Erythromycin: In healthy individual, plasma concentrations of atorvastatin increased by approximately 40% with coadministration of atorvastatin and erythromycin, a known inhibitor of cytochrome P450 3A4. The risk of myopathy is increased when statins and erythromycin are concurrently administered. Caution should be exercised when coadministering Tonact-FN with erythromycin.
Colestipol: Plasma concentrations of atorvastatin decreased approximately 25% when colestipol and atorvastatin were coadministered. However, LDL-C reduction was greater when atorvastatin and colestipol were coadministered than when either drug was given alone. Since bile acid sequestrants may bind other drugs given concurrently, patients should take Tonact-FN at least 1 hour before or 4-6 hours after a bile acid binding resin to avoid impending its absorption.
Digoxin: Administration of multiple doses of atorvastatin with digoxin increases the steady-state plasma digoxin concentrations by approximately 20%. Patients taking digoxin and Tonact-FN concomitantly should be monitored appropriately.
Oral Contraceptives: Co administration of atorvastatin and an oral contraceptive containing norethindrone and ethinyl estradiol produces increased plasma concentrations of norethindrone and ethinyl estradiol. These increases should be considered when selecting an oral contraceptive for a woman taking Tonact-FN.
Oral Anticoagulants: If coumarin anticoagulants and Tonact-FN are co administered, the dosage of the anticoagulant should be reduced to maintain the prothrombin time/INR at the desired level to prevent bleeding complications. Frequent prothrombin time/INR determinations are advisable until it has been definitely determined that the prothrombin time/INR has stabilized.
Cyclosporine: Because cyclosporine 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. The benefits and risk of using Tonact-FN with immunosuppressants and other potentially nephrotoxic agents should be carefully considered. Also, the risk of myopathy during treatment with statins is increased with concurrent administration of cyclosporine. Hence, caution should be exercised when coadministering Tonact-FN with cyclosporine.
Azole antifungals/Niacin: The risk of myopathy during treatment with statins is increases with concurrent administration of these agents. Hence caution should be exercised when these drugs are coadministered with Tonact-FN.
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