. . "004.005" . . . . "4.5\tInterakce s\u00A0jin\u00FDmi l\u00E9\u010Div\u00FDmi p\u0159\u00EDpravky a jin\u00E9 formy interakce"@cs . . . . . . "Farmakologick\u00E9 interakce\nSou\u010Dasn\u00E9 pod\u00E1v\u00E1n\u00ED s jin\u00FDmi l\u00E9\u010Div\u00FDmi p\u0159\u00EDpravky s anticholinergn\u00EDmi vlastnostmi m\u016F\u017Ee m\u00EDt za n\u00E1sledek v\u00FDrazn\u011Bj\u0161\u00ED l\u00E9\u010Debn\u00FD \u00FA\u010Dinek i ne\u017E\u00E1douc\u00ED \u00FA\u010Dinky. Mezi ukon\u010Den\u00EDm l\u00E9\u010Dby p\u0159\u00EDpravkem Soliflow a zah\u00E1jen\u00EDm jin\u00E9 anticholinergn\u00ED terapie je nutn\u00E1 p\u0159est\u00E1vka p\u0159ibli\u017En\u011B 1 t\u00FDden. L\u00E9\u010Debn\u00FD \u00FA\u010Dinek solifenacinu m\u016F\u017Ee b\u00FDt sn\u00ED\u017Een sou\u010Dasn\u00FDm pod\u00E1v\u00E1n\u00EDm agonist\u016F cholinergn\u00EDch receptor\u016F. \nSolifenacin m\u016F\u017Ee sni\u017Eovat \u00FA\u010Dinek l\u00E9\u010Div\u00FDch p\u0159\u00EDpravk\u016F, kter\u00E9 stimuluj\u00ED motilitu gastrointestin\u00E1ln\u00EDho traktu jako jsou metoklopramid a cisaprid. \nFarmakokinetick\u00E9 interakce\nStudie in vitro prok\u00E1zaly, \u017Ee v terapeutick\u00FDch koncentrac\u00EDch solifenacin neinhibuje CYP1A1/2, 2C9, 2C19, 2D6 nebo 3A4 z lidsk\u00FDch jatern\u00EDch mikroz\u00F3m\u016F. Solifenacin tedy pravd\u011Bpodobn\u011B neovliv\u0148uje clearance l\u00E9k\u016F metabolizovan\u00FDch t\u011Bmito CYP enzymy.\n\u00DA\u010Dinky ostatn\u00EDch l\u00E9\u010Div\u00FDch p\u0159\u00EDpravk\u016F na farmakokinetiku solifenacinu\nSolifenacin je metabolizov\u00E1n CYP3A4. Sou\u010Dasn\u00E9 pod\u00E1v\u00E1n\u00ED ketokonazolu (200 mg denn\u011B), siln\u00E9ho inhibitoru CYP3A4, m\u00E1 za n\u00E1sledek dvojn\u00E1sobn\u00E9 zv\u00FD\u0161en\u00ED AUC u solifenacinu. Pod\u00E1v\u00E1n\u00ED ketokonazolu v d\u00E1vce 400 mg denn\u011B vede k trojn\u00E1sobn\u00E9mu zv\u00FD\u0161en\u00ED AUC u solifenacinu. Pokud je tedy p\u0159\u00EDpravek Soliflow pod\u00E1v\u00E1n sou\u010Dasn\u011B s ketokonazolem nebo jin\u00FDmi potentn\u00EDmi inhibitory CYP3A4 (nap\u0159. ritonavir, nelfinavir, itrakonazol) v terapeutick\u00FDch d\u00E1vk\u00E1ch, m\u011Bla by se jeho maxim\u00E1ln\u00ED d\u00E1vka omezit na 5 mg (viz bod 4.2). Sou\u010Dasn\u00E1 l\u00E9\u010Dba solifenacinem a potentn\u00EDm inhibitorem CYP3A4 je kontraindikov\u00E1na u pacient\u016F se z\u00E1va\u017En\u00FDm po\u0161kozen\u00EDm ledvin a st\u0159edn\u011B z\u00E1va\u017En\u00FDm po\u0161kozen\u00EDm jater. \n\u00DA\u010Dinky indukce enzym\u016F na farmakokinetiku solifenacinu a jeho metabolit\u016F nebyly studov\u00E1ny, stejn\u011B jako vliv substr\u00E1t\u016F s vy\u0161\u0161\u00ED afinitou k CYP3A4 na expozici solifenacinu. Vzhledem k tomu, \u017Ee solifenacin je metabolizov\u00E1n CYP3A4, jsou mo\u017En\u00E9 farmakokinetick\u00E9 interakce s jin\u00FDmi substr\u00E1ty s vy\u0161\u0161\u00ED afinitou k CYP3A4 (nap\u0159. verapamil, diltiazem) a s induktory CYP3A4 (nap\u0159. rifampicin, fenytoin, karbamazepin). \n\u00DA\u010Dinek solifenacinu na farmakokinetiku ostatn\u00EDch l\u00E9\u010Div\u00FDch p\u0159\u00EDpravk\u016F\nOr\u00E1ln\u00ED kontraceptiva\nSoliflow nevykazuje \u017E\u00E1dnou farmakokinetickou interakci solifenacinu s kombinovan\u00FDmi or\u00E1ln\u00EDmi kontraceptivy (ethinylestradiol/levonorgestrel).\n \nWarfarin\nSoliflow nem\u011Bn\u00ED farmakokinetiku R-warfarinu nebo S-warfarinu nebo jejich \u00FA\u010Dinek na protrombinov\u00FD \u010Das.\nDigoxin\nSoliflow nem\u00E1 \u017E\u00E1dn\u00FD vliv na farmakokinetiku digoxinu.\nL\u00E9\u010Debn\u00E9 p\u0159\u00EDpravky, kter\u00E9 stimuluj\u00ED motilitu gastrointestin\u00E1ln\u00EDho traktu\nSolifenacin m\u016F\u017Ee sni\u017Eovat \u00FA\u010Dinek l\u00E9\u010Div\u00FDch p\u0159\u00EDpravk\u016F, kter\u00E9 stimuluj\u00ED motilitu gastrointestin\u00E1ln\u00EDho traktu, jako jsou metoklopramid a cisaprid.\n"@cs . . . . .