"4.5 \tInterakce s jin\u00FDmi l\u00E9\u010Div\u00FDmi p\u0159\u00EDpravky a jin\u00E9 formy interakce"@cs . "Soub\u011B\u017En\u00E9 systematick\u00E9 pod\u00E1v\u00E1n\u00ED \u00A0siln\u00FDch inhibitor\u016F CYP3A4 jako makrolidov\u00FDch antibiotik (nap\u0159. erytromycin a klaritromycin), l\u00E9k\u016F proti pl\u00EDsn\u00EDm (nap\u0159. ketokonazol a itrakonazol) a antiprote\u00E1z se nedoporu\u010Duje kv\u016Fli zv\u00FD\u0161en\u00FDm s\u00E9rov\u00FDm koncentrac\u00EDm tolterodinu u pomal\u00FDch metaboliz\u00E1tor\u016F CYP2D6 s (n\u00E1sledn\u00FDm) rizikem p\u0159ed\u00E1vkov\u00E1n\u00ED (viz bod 4.4).\nSoub\u011B\u017En\u00E9 pod\u00E1v\u00E1n\u00ED jin\u00FDch l\u00E9\u010Div\u00FDch p\u0159\u00EDpravk\u016F s antimuskarinov\u00FDmi vlastnostmi jako amantadin, n\u011Bkter\u00E9 antihistaminy, fenotiazinov\u00E1 antipsychotika a tricyklick\u00E1 antidepresiva mohou v\u00E9st k v\u00FDrazn\u011Bj\u0161\u00EDmu l\u00E9\u010Debn\u00E9mu \u00FA\u010Dinku a ne\u017E\u00E1douc\u00EDm \u00FA\u010Dink\u016Fm tolterodinu. Naproti tomu se m\u016F\u017Ee l\u00E9\u010Debn\u00FD \u00FA\u010Dinek tolterodinu sn\u00ED\u017Eit soub\u011B\u017En\u00FDm pod\u00E1v\u00E1n\u00EDm agonist\u016F muskarinov\u00FDch cholinergn\u00EDch receptor\u016F. Sn\u00ED\u017Een\u00ED \u017Ealude\u010Dn\u00ED motility zp\u016Fsoben\u00E9 antimuskariniky m\u016F\u017Ee ovlivnit absorpci jin\u00FDch l\u00E9k\u016F.\nTolterodin m\u016F\u017Ee sni\u017Eovat \u00FA\u010Dinky prokinetik jako je metoklopramid, domperidon a cisaprid.\nSoub\u011B\u017En\u00E1 l\u00E9\u010Dba fluoxetinem (siln\u00FD inhibitor CYP2D6) nem\u00E1 za n\u00E1sledek klinicky v\u00FDznamnou interakci, proto\u017Ee tolterodin a jeho metabolit z\u00E1visl\u00FD na CYP2D6 , 5-hydroxymetylov\u00FD tolterodin, jsou ekvipotentn\u00ED.\nStudie interakce s\u00A0l\u00E9\u010Div\u00FDmi p\u0159\u00EDpravky neprok\u00E1zaly \u017E\u00E1dn\u00E9 interakce s warfarinem anebo kombinovan\u00FDmi peror\u00E1ln\u00EDmi antikoncep\u010Dn\u00EDmi p\u0159\u00EDpravky (etinylestradiol/levonorgestrel).\nKlinick\u00E1 studie nazna\u010Dila, \u017Ee tolterodin nen\u00ED metabolick\u00FD inhibitor CYP2D6, 2C19, 2C9, 3A4 ani 1A2. Proto se nep\u0159edpokl\u00E1d\u00E1 zv\u00FD\u0161en\u00ED plazmatick\u00FDch hladin l\u00E9\u010Div\u00FDch p\u0159\u00EDpravk\u016F metabolizovan\u00FDch t\u011Bmito izoenzymy p\u0159i pod\u00E1v\u00E1n\u00ED v kombinaci s tolterodinem.\n"@cs . . . . . . . . . "004.005" .