Other drugs Antacids: set reduction in primobolan depot dosage of amprenavir by 18% and 35%, respectively, while increasing the C min upon receipt of a single dose of 1400 mg of fosamprenavir with a single dose of 30 mL of an antacid suspension (equivalent to 2.75 g of aluminum hydroxide and magnesium hydroxide, 1.8 g). Any dose adjustment of these drugs when combined use is not required. The antagonists histamine receptors: the concentration of amprenavir in the blood can be reduced in the combined use of antagonists of H 2 histamine receptors (for example, while taking ranitidine and cimetidine). Joint reception of ranitidine (300 mg single dose) with fosamprenavir (1400 mg single dose) reduces plasma amprenavir
However, the index of amprenavir remains unchanged. Dose adjustment when coadministered to any of the herein preparations are required. Proton pump inhibitors: the combined use of antacids 1400 mg twice a day and of esomeprazole 20 mg per day for 14 days increased the esomeprazole without affecting . Corrections dosing regimen in this case is not required. The drugs with a narrow therapeutic range: while the use of fosamprenavir with drugs such asamiodarone, quinidine, lidocaine (systemic route of administration), tricyclic antidepressants and warfarin requires monitoring concentrations of these drugs in the blood plasma in connection with the possibility of life-threatening conditions. For warfarin need to monitor the international normalized ratio .
The following list of drugs are examples of substrates, inhibitors or inducers primobolan depot dosage, which may interact with fosamprenavir with simultaneous application. The list is not exhaustive. The clinical relevance of these potential interactions is not known or is not fully understood. In this connection it should pay special attention to monitoring the toxic effects of these drugs while their reception with fosamprenavir. Alfuzosin: Serum concentrations may be increased, which may lead to an increased risk of arterial hypotension. Anticonvulsants co-administration of anticonvulsants, inducers of enzymes ( phenytoin, phenobarbital, carbamazepine) with fosamprenavir without the concurrent use of low-dose ritonavir may reduce the concentration of amprenavir plasma. Benzodiazepines (alprazolam, clorazepate, diazepam, flurazepam) may increase their serum concentrations that can lead to an enhancement of their activity. calcium channel blockers (amlodipine, diltiazem, felodipine, isradipine, nicardipine, nifedipine, nimodipine, nisoldipine and verapamil) may increase their serum concentrations that can lead to an enhancement of their activity and toxicity. It is recommended to monitor the concentration of these drugs in the blood. Dexamethasone: may induce the isozyme or decrease in the plasma concentration of amprenavir. Inhibitors of phosphodiesterase-5: concentration of sildenafil in plasma can rise significantly, while the application antacids, which may increase the incidence of adverse reactions and other inhibitors sildenafil fosfodiesterazy- 5 (hypotension, blurred vision, priapism). Concomitant use of antacids and sildenafil, vardenafil is not recommended. Fluticasone propionate (interaction with ritonavir) has been shown a significant increase in serum concentrations of fluticasone propionate, while the use of 200 mcg of fluticasone nasal and 100 mg of ritonavir twice daily. It is expected that this increase substantially increases the risk of systemic adverse reactions fluticasone. Reports on the development of systemic adverse effects include Cushing’s syndrome, adrenal suppression. Such interaction is predicted for all glucocorticosteroids metabolized isoenzyme .
Inhibitors of hydroxymethylglutaryl-CoA reductase (HMG-CoA reductase) metabolism reductase inhibitors ( lovastatin and simvastatin ) is largely dependent on , and therefore the combined the use of fosamprenavir and ritonavir with lovastatin or simvastatin is not recommended due to an increased risk of myopathy, including rhabdomyolysis. Precautions should be prescribed fosamprenavir with atorvastatin , which is also metabolized to a lesser extent than lovastatin and simvastatin. The recommended dose of atorvastatin is not more than 20 mg per day. Metabolism of pravastatin and fluvastatin is not dependent on primobolan depot dosage is therefore likely that in this case, the interaction with protease inhibitors available. Pravastatin and fluvastatin are recommended when shown therapy with drugs from the group of inhibitors of HMG-CoA reductase. Immunosuppressants: one can expect an increase in the plasma concentration of cyclosporine, rapamycin and tacrolimus with simultaneous administration with fosamprenavir. For this reason recommended frequent monitoring of therapeutic concentrations of these drugs as long as the levels become stable. Bepridil: to avoid simultaneous administration of a combination fosamprenavir + ritonavir and bepridil due to the fact that amprenavir and ritonavir are inhibitors of the cytochrome CYP3A4 involved in the metabolism bepridil, which can lead to higher blood concentrations bepridil and increase the risk of arrhythmias, of life-threatening.methadone: amprenavir reduces the concentration of methadone in the plasma. If concomitant administration of methadone with fosamprenavir must be constant monitoring of patients in connection with the development of withdrawal symptoms after opiate withdrawal and simultaneously monitor the concentration of methadone plasma. Paroxetine: serum concentrations of paroxetine may be significantly reduced, while the appointment with fosamprenavir and ritonavir, thus requiring adequate correction of the dosing of paroxetine, depending on the clinical effect and tolerability. steroids: estrogens, progestogens, and some may interact with the glucocorticoid amprenavir. However, data on such interactions are absent. Due to the possibility of the metabolic interaction with amprenavir can change the effectiveness of hormonal contraceptives. Therefore recommended alternative methods of contraception for women of reproductive age. Products containing St. John’s wort: amprenavir concentrations in the blood may be reduced due to the concomitant use of drugs containingprimobolan depot dosage wort ( of Hypericum perforatum ), which is associated with the induction of metabolizing enzymes of drugs Hypericum perforatum. Therefore Hypericum perforatum drugs should not be used simultaneously with fosamprenavir therapy. The inducing effect of wort may persist for 2 weeks after its cancellation.
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