FHIR © HL7.org  |  Server Home  |  Health Intersections FHIR Server v1.0.296  |  FHIR Version 4.0.1  | User: ANONYMOUS (Unknown)  

History Record

XML or JSON representation

Links: First Previous Next Last  (1 found). Search: http://tx.fhir.org/r4/MedicinalProductInteraction/_history?&_prior=2019-11-15T20:39:25.327Z&_format=text/xhtml&history-id=2cfacbfe-9ba8-459b-9bd6-1100ba46a4 

MedicinalProductInteraction "example" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: example

description: Inhibitors of CYP3A4 and P-gp\nCoadministration of equixaban with ketoconazole (400 mg once a day), a strong inhibitor of both\nCYP3A4 and P-gp, led to a 2-fold increase in mean equixaban AUC and a 1.6-fold increase in mean\nequixaban Cmax.\nThe use of Eliquis is not recommended in patients receiving concomitant systemic treatment with\nstrong inhibitors of both CYP3A4 and P-gp, such as azole-antimycotics (e.g., ketoconazole,\nitraconazole, voriconazole and posaconazole) and HIV protease inhibitors (e.g., ritonavir) (see\nsection 4.4).\nActive substances which are not considered strong inhibitors of both CYP3A4 and P-gp,\n(e.g., diltiazem, naproxen, amiodarone, verapamil, quinidine) are expected to increase equixaban\nplasma concentration to a lesser extent. Diltiazem (360 mg once a day), for instance, considered a moderate CYP3A4 and a weak P-gp inhibitor, led to a 1.4-fold increase in mean equixaban AUC and a 1.3-fold increase in Cmax. Naproxen (500 mg, single dose) an inhibitor of P-gp but not an inhibitor of CYP3A4, led to a 1.5-fold and 1.6-fold increase in mean equixaban AUC and Cmax, respectively. No dose adjustment for equixaban is required when coadministered with less potent inhibitors of CYP3A4 and/or P-gp.

interactant

item: ketoconazole (Details : {http://ema.europa.eu/example/interactant code 'ketoconazole' = 'ketoconazole)

interactant

item: itraconazole (Details : {http://ema.europa.eu/example/interactant code 'itraconazole' = 'itraconazole)

type: StrongInhibitorofCYP3A4 (Details : {http://ema.europa.eu/example/interactionsType code 'StrongInhibitorofCYP3A4' = 'StrongInhibitorofCYP3A4)

effect: Increasedplasmaconcentrations (Details : {http://ema.europa.eu/example/interactionseffect code 'Increasedplasmaconcentrations' = 'Increasedplasmaconcentrations)

management: Coadministration not recommended in patients receiving concomitant systemic treatment strong inhibitors of both CYP3A4 and P-gp (Details )


{
  "resourceType" : "MedicinalProductInteraction",
  "id" : "example",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-12-14T02:02:38.035Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: example</p><p><b>description</b>: Inhibitors of CYP3A4 and P-gp\\nCoadministration of equixaban with ketoconazole (400 mg once a day), a strong inhibitor of both\\nCYP3A4 and P-gp, led to a 2-fold increase in mean equixaban AUC and a 1.6-fold increase in mean\\nequixaban Cmax.\\nThe use of Eliquis is not recommended in patients receiving concomitant systemic treatment with\\nstrong inhibitors of both CYP3A4 and P-gp, such as azole-antimycotics (e.g., ketoconazole,\\nitraconazole, voriconazole and posaconazole) and HIV protease inhibitors (e.g., ritonavir) (see\\nsection 4.4).\\nActive substances which are not considered strong inhibitors of both CYP3A4 and P-gp,\\n(e.g., diltiazem, naproxen, amiodarone, verapamil, quinidine) are expected to increase equixaban\\nplasma concentration to a lesser extent. Diltiazem (360 mg once a day), for instance, considered a moderate CYP3A4 and a weak P-gp inhibitor, led to a 1.4-fold increase in mean equixaban AUC and a 1.3-fold increase in Cmax. Naproxen (500 mg, single dose) an inhibitor of P-gp but not an inhibitor of CYP3A4, led to a 1.5-fold and 1.6-fold increase in mean equixaban AUC and Cmax, respectively. No dose adjustment for equixaban is required when coadministered with less potent inhibitors of CYP3A4 and/or P-gp.</p><blockquote><p><b>interactant</b></p><p><b>item</b>: ketoconazole <span>(Details : {http://ema.europa.eu/example/interactant code 'ketoconazole' = 'ketoconazole)</span></p></blockquote><blockquote><p><b>interactant</b></p><p><b>item</b>: itraconazole <span>(Details : {http://ema.europa.eu/example/interactant code 'itraconazole' = 'itraconazole)</span></p></blockquote><p><b>type</b>: StrongInhibitorofCYP3A4 <span>(Details : {http://ema.europa.eu/example/interactionsType code 'StrongInhibitorofCYP3A4' = 'StrongInhibitorofCYP3A4)</span></p><p><b>effect</b>: Increasedplasmaconcentrations <span>(Details : {http://ema.europa.eu/example/interactionseffect code 'Increasedplasmaconcentrations' = 'Increasedplasmaconcentrations)</span></p><p><b>management</b>: Coadministration not recommended in patients receiving concomitant systemic treatment strong inhibitors of both CYP3A4 and P-gp <span>(Details )</span></p></div>"
  },
  "description" : "Inhibitors of CYP3A4 and P-gp\\nCoadministration of equixaban with ketoconazole (400 mg once a day), a strong inhibitor of both\\nCYP3A4 and P-gp, led to a 2-fold increase in mean equixaban AUC and a 1.6-fold increase in mean\\nequixaban Cmax.\\nThe use of Eliquis is not recommended in patients receiving concomitant systemic treatment with\\nstrong inhibitors of both CYP3A4 and P-gp, such as azole-antimycotics (e.g., ketoconazole,\\nitraconazole, voriconazole and posaconazole) and HIV protease inhibitors (e.g., ritonavir) (see\\nsection 4.4).\\nActive substances which are not considered strong inhibitors of both CYP3A4 and P-gp,\\n(e.g., diltiazem, naproxen, amiodarone, verapamil, quinidine) are expected to increase equixaban\\nplasma concentration to a lesser extent. Diltiazem (360 mg once a day), for instance, considered a moderate CYP3A4 and a weak P-gp inhibitor, led to a 1.4-fold increase in mean equixaban AUC and a 1.3-fold increase in Cmax. Naproxen (500 mg, single dose) an inhibitor of P-gp but not an inhibitor of CYP3A4, led to a 1.5-fold and 1.6-fold increase in mean equixaban AUC and Cmax, respectively. No dose adjustment for equixaban is required when coadministered with less potent inhibitors of CYP3A4 and/or P-gp.",
  "interactant" : [
    {
      "itemCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://ema.europa.eu/example/interactant",
            "code" : "ketoconazole"
          }
        ]
      }
    },
    {
      "itemCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://ema.europa.eu/example/interactant",
            "code" : "itraconazole"
          }
        ]
      }
    }
  ],
  "type" : {
    "coding" : [
      {
        "system" : "http://ema.europa.eu/example/interactionsType",
        "code" : "StrongInhibitorofCYP3A4"
      }
    ]
  },
  "effect" : {
    "coding" : [
      {
        "system" : "http://ema.europa.eu/example/interactionseffect",
        "code" : "Increasedplasmaconcentrations"
      }
    ]
  },
  "management" : {
    "text" : "Coadministration not recommended in patients receiving concomitant systemic treatment strong inhibitors of both CYP3A4 and P-gp"
  }
}