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1 | PRE_PPS-N_v3.0.1.zip\PS_PPS_ui\src\test\resources\messages | orderCheckResponse4.xml | Fri Jan 12 15:43:08 2018 UTC |
2 | PRE_PPS-N_v3.0.1.zip\PS_PPS_ui\src\test\resources\messages | orderCheckResponse4.xml | Fri Mar 2 23:18:25 2018 UTC |
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1 | <?xml | |
2 | version="1 .0" | |
3 | encoding=" UTF-8" | |
4 | ?> | |
5 | <PEPSRespo nse | |
6 | xmlns="gov /va/med/ph armacy/pep s/external /common/pr eencapsula tion/vo/dr ug/check/r esponse" | |
7 | > | |
8 | ||
9 | <Header> | |
10 | ||
11 | <Time | |
12 | value="084 5" | |
13 | /> | |
14 | ||
15 | <MServer | |
16 | namespace= "VISTA" | |
17 | uci="text" | |
18 | ip=" IP " | |
19 | ||
20 | serverName ="Server N ame" | |
21 | stationNum ber="45" | |
22 | /> | |
23 | ||
24 | <MUser | |
25 | userName=" user" | |
26 | duz="88660 079" | |
27 | jobNumber= "1004" | |
28 | /> | |
29 | ||
30 | <PEPSVersi on | |
31 | difIssueDa te="200810 20" | |
32 | difBuildVe rsion="6" | |
33 | difDbVersi on="3.2" | |
34 | /> | |
35 | ||
36 | </Header> | |
37 | ||
38 | <Body> | |
39 | ||
40 | <drugCheck > | |
41 | ||
42 | <drugDrugC hecks> | |
43 | ||
44 | <drugDrugC heck> | |
45 | ||
46 | <interacte dDrugList> | |
47 | ||
48 | <drug | |
49 | orderNumbe r="Z;1;Pro spect" | |
50 | ien="1812" | |
51 | vuid="3333 " | |
52 | gcnSeqNo=" 25485" | |
53 | /> | |
54 | ||
55 | <drug | |
56 | orderNumbe r="A3333" | |
57 | ien="93" | |
58 | vuid="4444 " | |
59 | gcnSeqNo=" 266" | |
60 | /> | |
61 | ||
62 | </interact edDrugList > | |
63 | ||
64 | <severity> | |
65 | Contraindi cated Drug Combinati on | |
66 | </severity > | |
67 | ||
68 | <interacti on> | |
69 | SELECTED P ROTEASE IN HIBITORS/A MIODARONE | |
70 | </interact ion> | |
71 | ||
72 | <shortText > | |
73 | INDINAVIR SULFATE OR AL CAPSULE 400 MG an d AMIODARO NE HCL ORA L TABLET 2 00 MG may interact b ased on th e potentia l interact ion betwee n SELECTED PROTEASE INHIBITORS and AMIOD ARONE. | |
74 | </shortTex t> | |
75 | ||
76 | <professio nalMonogra ph> | |
77 | ||
78 | <monograph Source> | |
79 | FDB | |
80 | </monograp hSource> | |
81 | ||
82 | <disclaime r> | |
83 | This infor mation is generalize d and not intended a s specific medical a dvice. Con sult your healthcare professio nal before taking or discontin uing any d rug or com mencing an y course o f treatmen t. | |
84 | </disclaim er> | |
85 | ||
86 | <monograph Title> | |
87 | MONOGRAPH TITLE: Se lected Pro tease Inhi bitors/Ami odarone | |
88 | </monograp hTitle> | |
89 | ||
90 | <severityL evel> | |
91 | SEVERITY L EVEL: 1-C ontraindic ated Drug Combinatio n: This dr ug combina tion is co ntraindica ted and ge nerally sh ould not b e dispense d or admin istered to the same patient. | |
92 | </severity Level> | |
93 | ||
94 | <mechanism OfAction> | |
95 | MECHANISM OF ACTION: Indinavi r,(1) nelf inavir,(2) ritonavir ,(3) and t ipranavir coadminist ered with ritonavir( 4) may inh ibit the m etabolism of amiodar one at CYP P-450-3A4 . | |
96 | </mechanis mOfAction> | |
97 | ||
98 | <clinicalE ffects> | |
99 | CLINICAL E FFECTS: T he concurr ent admini stration o f amiodaro ne with in dinavir,(1 ) nelfinav ir,(2) rit onavir,(3) or tipran avir coadm inistered with riton avir(4) ma y result i n increase d levels, clinical e ffects, an d toxicity of amioda rone. | |
100 | </clinical Effects> | |
101 | ||
102 | <predispos ingFactors > | |
103 | PREDISPOSI NG FACTORS : None de termined. | |
104 | </predispo singFactor s> | |
105 | ||
106 | <patientMa nagement> | |
107 | PATIENT MA NAGEMENT: The concu rrent admi nistration of amioda rone with indinavir, (1) nelfin avir(2), r itonavir,( 3) or tipr anavir coa dministere d with rit onavir(4) is contrai ndicated b y the manu facturers of indinav ir,(1) nel finavir(2) , ritonavi r,(3) and tipranavir coadminis tered with ritonavir . (4) | |
108 | </patientM anagement> | |
109 | ||
110 | <discussio n> | |
111 | DISCUSSION : Indinav ir has bee n shown to inhibit C YP P-450-3 A4. There fore, the manufactur er of indi navir stat es that th e concurre nt adminis tration of indinavir with amio darone, wh ich is met abolized b y CYP P-45 0-3A4, is contraindi cated.(1)N elfinavir has been s hown to in hibit CYP P-450-3A4. Therefor e, the man ufacturer of nelfina vir states that the concurrent administr ation of n elfinavir with amiod arone, whi ch is meta bolized by CYP P-450 -3A4, is c ontraindic ated.(2)Ri tonavir ha s also bee n shown to inhibit C YP P-450-3 A4. Theref ore, the m anufacture r of riton avir state that the concurrent administr ation of r itonavir w ith amioda rone is co ntraindica ted.(3) | |
112 | </discussi on> | |
113 | ||
114 | <reference s> | |
115 | ||
116 | <reference > | |
117 | <![CDATA[R EFERENCES: ]]> | |
118 | </referenc e> | |
119 | ||
120 | <reference > | |
121 | <![CDATA[1 .Crixivan (indinavir sulfate) US prescri bing infor mation. Me rck & Co., Inc. July , 2007.]]> | |
122 | </referenc e> | |
123 | ||
124 | <reference > | |
125 | <![CDATA[2 .Viracept (nelfinavi r mesylate ) US presc ribing inf ormation. Agouron Ph armaceutic als, Inc. July, 2007 .]]> | |
126 | </referenc e> | |
127 | ||
128 | <reference > | |
129 | <![CDATA[3 .Norvir (r itonavir) US prescri bing infor mation. Ab bott Labor atories Au gust, 2008 .]]> | |
130 | </referenc e> | |
131 | ||
132 | </referenc es> | |
133 | ||
134 | </professi onalMonogr aph> | |
135 | ||
136 | </drugDrug Check> | |
137 | ||
138 | <drugDrugC heck> | |
139 | ||
140 | <interacte dDrugList> | |
141 | ||
142 | <drug | |
143 | orderNumbe r="A3333" | |
144 | ien="93" | |
145 | vuid="4444 " | |
146 | gcnSeqNo=" 266" | |
147 | /> | |
148 | ||
149 | <drug | |
150 | orderNumbe r="B;L34" | |
151 | ien="95" | |
152 | vuid="6666 " | |
153 | gcnSeqNo=" 6562" | |
154 | /> | |
155 | ||
156 | </interact edDrugList > | |
157 | ||
158 | <severity> | |
159 | Severe Int eraction | |
160 | </severity > | |
161 | ||
162 | <interacti on> | |
163 | AMIODARONE /ANTICOAGU LANTS | |
164 | </interact ion> | |
165 | ||
166 | <shortText > | |
167 | AMIODARONE HCL ORAL TABLET 200 MG and WA RFARIN SOD IUM ORAL T ABLET 5 MG may inter act based on the pot ential int eraction b etween AMI ODARONE an d ANTICOAG ULANTS. | |
168 | </shortTex t> | |
169 | ||
170 | <professio nalMonogra ph> | |
171 | ||
172 | <monograph Source> | |
173 | FDB | |
174 | </monograp hSource> | |
175 | ||
176 | <disclaime r> | |
177 | This infor mation is generalize d and not intended a s specific medical a dvice. Con sult your healthcare professio nal before taking or discontin uing any d rug or com mencing an y course o f treatmen t. | |
178 | </disclaim er> | |
179 | ||
180 | <monograph Title> | |
181 | MONOGRAPH TITLE: Am iodarone/A nticoagula nts | |
182 | </monograp hTitle> | |
183 | ||
184 | <severityL evel> | |
185 | SEVERITY L EVEL: 2-S evere Inte raction: A ction is r equired to reduce th e risk of severe adv erse inter action. | |
186 | </severity Level> | |
187 | ||
188 | <mechanism OfAction> | |
189 | MECHANISM OF ACTION: Amiodaro ne has bee n shown to inhibit t he metabol ism of the R- and S- enantiomer s of warfa rin by CYP P-450 in vitro and in vivo.(1 -4) Amioda rone may a lso inhibi t the meta bolism of acenocouma rol(5) and other ant icoagulant s. | |
190 | </mechanis mOfAction> | |
191 | ||
192 | <clinicalE ffects> | |
193 | CLINICAL E FFECTS: T he concurr ent admini stration o f amiodaro ne and an anticoagul ant may re sult in an increase in the cli nical effe cts of the anticoagu lant and a n increase d risk of bleeding.( 1-22) It may take s everal wee ks of conc urrent the rapy befor e the full effects o f this int eraction a re noted. The effec t of amiod arone on a nticoagula nt levels may contin ue for sev eral month s after am iodarone i s disconti nued. | |
194 | </clinical Effects> | |
195 | ||
196 | <predispos ingFactors > | |
197 | PREDISPOSI NG FACTORS : Amiodar one-induce d thyrotox icosis may increase the metabo lic cleara nce of som e vitamin K-dependen t clotting factors, decreasing anticoagu lant requi rements.(6 ) | |
198 | </predispo singFactor s> | |
199 | ||
200 | <patientMa nagement> | |
201 | PATIENT MA NAGEMENT: If both d rugs are a dministere d concurre ntly, adju st the ant icoagulant dose as n eeded base d on caref ully monit ored proth rombin act ivity. Th e US manuf acturer of amiodaron e recommen ds decreas ing the an ticoagulan t dose by 1/3 to 1/2 , followed by close monitoring of prothr ombin acti vity.(22) | |
202 | </patientM anagement> | |
203 | ||
204 | <discussio n> | |
205 | DISCUSSION : Several studies a nd case re ports have documente d the pote ntial inte raction be tween warf arin and a miodarone. In sever al studies , the dosa ge of warf arin had t o be decre ased betwe en 32.9% a nd 70% to maintain s atisfactor y prothrom bin activi ty.(1-4,6- 11)Several case repo rts and re trospectiv e chart re views have also docu mented the potential interacti on between amiodaron e and acen ocoumarol. The dosa ge reducti on of acen ocoumarol required t o maintain satisfact ory prothr ombin acti vity range d from 20% to 60%.(1 2-18)A cas e report d escribes a 66-year-o ld male wi th a histo ry of recu rrent atri al fibrill ation. Wh ile taking both amio darone and a low-dos e warfarin therapy, prothrombi n times we re prolong ed, INR va lues were increased and bleedi ng occurre d. Both d rugs were withheld, and the ef fect of th e interact ion contin ued for an extended period of time.(19)O ne study e valuated t he role de sethylamio darone, th e active m etabolite of amiodar one, playe d on concu rrent warf arin thera py. After analyzing 25 patien ts with st ructural h eart disea se and arr hythmias, it was fou nd that th e concentr ation of d esethylami odarone pl ayed a lar ger role i n augmenti ng the INR , than the concentra tion of am iodarone a lone. Add itional ex amination revealed t hat amioda rone prima rily inhib its CYP P- 450-1A2 an d CYP P-45 0-3A4, whe reas deset hylamiodar one primar ily inhibi ts CYP P-4 50-2C9, th e isozyme responsibl e for the metabolism of S-warf arin.(20)A n observat ional, coh ort study reviewed t he interac tion of am iodarone w ith warfar in for a p eriod of a t least on e year, wh ile evalua ting the a djustments needed to achieve a n INR rati o between 2 and 3. After anal yzing 43 p atients, b aseline wa rfarin the rapy requi red a mean 44% reduc tion in do se after s even weeks of coadmi nistration with amio darone. F ive subjec ts experie nced minor bleeding. For pati ents recei ving amiod arone main tenance, w arfarin do se reducti ons were a s follows: 400 mg/d, reduce wa rfarin dos e 40%; 300 mg/d, red uce warfar in dose 35 %; 200/d, reduce war farin dose 30%; and 100 mg/d, reduce war farin dose by 25%. All warfar in dose re ductions a re approxi mations an d must be based on a ggressive INR monito ring.(21) | |
206 | </discussi on> | |
207 | ||
208 | <reference s> | |
209 | ||
210 | <reference > | |
211 | <![CDATA[R EFERENCES: ]]> | |
212 | </referenc e> | |
213 | ||
214 | <reference > | |
215 | <![CDATA[1 .Almog S, Shafran N, Halkin H, Weiss P, Farfel Z, Martinowit z U, Bank H. Mechani sm of warf arin poten tiation by amiodaron e: dose--a nd concent ration--de pendent in hibition o f warfarin eliminati on. Eur J Clin Pharm acol 1985; 28(3):257- 61.]]> | |
216 | </referenc e> | |
217 | ||
218 | <reference > | |
219 | <![CDATA[2 .Rees A, D alal JJ, R eid PG, He nderson AH , Lewis MJ . Dangers of amiodar one and an ticoagulan t treatmen t. Br Med J (Clin Re s Ed) 1981 May 30; 2 82(6278):1 756-7.]]> | |
220 | </referenc e> | |
221 | ||
222 | <reference > | |
223 | <![CDATA[3 .O'Reilly RA, Trager WF, Retti e AE, Goul art DA. In teraction of amiodar one with r acemic war farin and its separa ted enanti omorphs in humans. C lin Pharma col Ther 1 987 Sep;42 (3):290-4. ]]> | |
224 | </referenc e> | |
225 | ||
226 | <reference > | |
227 | <![CDATA[4 .Heimark L D, Wienker s L, Kunze K, Gibald i M, Eddy AC, Trager WF, O'Rei lly RA, Go ulart DA. The mechan ism of the interacti on between amiodaron e and warf arin in hu mans. Clin Pharmacol Ther 1992 Apr;51(4) :398-407.] ]> | |
228 | </referenc e> | |
229 | ||
230 | <reference > | |
231 | <![CDATA[5 .Richard C , Riou B, Berdeaux A , Fournier C, Khayat D, Rimail ho A, Giud icelli JF, Auzepy P. Prospecti ve study o f the pote ntiation o f acenocou marol by a miodarone. Eur J Cli n Pharmaco l 1985;28( 6):625-9.] ]> | |
232 | </referenc e> | |
233 | ||
234 | <reference > | |
235 | <![CDATA[6 .Woeber KA , Warner I . Potentia tion of wa rfarin sod ium by ami odarone-in duced thyr otoxicosis . West J M ed 1999 Ja n;170(1):4 9-51.]]> | |
236 | </referenc e> | |
237 | ||
238 | <reference > | |
239 | <![CDATA[7 .Watt AH, Stephens M R, Buss DC , Routledg e PA. Amio darone red uces plasm a warfarin clearance in man. B r J Clin P harmacol 1 985 Dec;20 (6):707-9. ]]> | |
240 | </referenc e> | |
241 | ||
242 | <reference > | |
243 | <![CDATA[8 .Hamer A, Peter T, M andel WJ, Scheinman MM, Weiss D. The pot entiation of warfari n anticoag ulation by amiodaron e. Circula tion 1982 May;65(5): 1025-9.]]> | |
244 | </referenc e> | |
245 | ||
246 | <reference > | |
247 | <![CDATA[9 .Martinowi tz U, Rabi novich J, Goldfarb D , Many A, Bank H. In teraction between wa rfarin sod ium and am iodarone. N Engl J M ed 1981 Ma r 12; 304( 11):671-2. ]]> | |
248 | </referenc e> | |
249 | ||
250 | <reference > | |
251 | <![CDATA[1 0.Serlin M J, Sibeon RG, Green GJ. Danger s of amiod arone and anticoagul ant treatm ent. Br Me d J (Clin Res Ed) 19 81 Jul 4;2 83(6283):5 8.]]> | |
252 | </referenc e> | |
253 | ||
254 | <reference > | |
255 | <![CDATA[1 1.Kerin NZ , Blevins RD, Goldma n L, Faite l K, Ruben fire M. Th e incidenc e, magnitu de, and ti me course of the ami odarone-wa rfarin int eraction. Arch Inter n Med 1988 Aug;148(8 ):1779-81. ]]> | |
256 | </referenc e> | |
257 | ||
258 | <reference > | |
259 | <![CDATA[1 2.Arboix M , Frati ME , Laporte JR. The po tentiation of acenoc oumarol an ticoagulan t effect b y amiodaro ne. Br J C lin Pharma col 1984 S ep; 18(3): 355-60.]]> | |
260 | </referenc e> | |
261 | ||
262 | <reference > | |
263 | <![CDATA[1 3.Cheung B , Lam FM, Kumana CR. Insidious ly evolvin g, occult drug inter action inv olving war farin and amiodarone . BMJ 1996 Jan 13; 3 12(7023):1 07-8.]]> | |
264 | </referenc e> | |
265 | ||
266 | <reference > | |
267 | <![CDATA[1 4.El Allaf D, Spryng er M, Carl ier J. Pot entiation of the act ion of ora l anticoag ulants by amiodarone . Acta Cli n Belg 198 4;39(5):30 6-8.]]> | |
268 | </referenc e> | |
269 | ||
270 | <reference > | |
271 | <![CDATA[1 5.Fondevil a C, Mesch engieser S , Lazzari MA. Amioda rone poten tiates ace nocoumarin . Thromb R es 1989 Ja n 15;53(2) :203-8.]]> | |
272 | </referenc e> | |
273 | ||
274 | <reference > | |
275 | <![CDATA[1 6.Caraco Y , Raveh D, Flugelman M, Raz I. Enhanced anticoagul ant effect of acenoc oumarol in duced by a miodarone coadminist ration. Is r J Med Sc i 1988 Nov ;24(11):68 8-9.]]> | |
276 | </referenc e> | |
277 | ||
278 | <reference > | |
279 | <![CDATA[1 7.Pini M, Manotti C, Quintaval la R. Inte raction be tween amio darone and acenocoum arin. Thro mb Haemost 1985 Aug 30;54(2):5 49.]]> | |
280 | </referenc e> | |
281 | ||
282 | <reference > | |
283 | <![CDATA[1 8.Caraco Y , Chajek-S haul T. Th e incidenc e and clin ical signi ficance of amiodaron e and acen ocoumarol interactio n. Thromb Haemost 19 89 Nov 24; 62(3):906 -8.]]> | |
284 | </referenc e> | |
285 | ||
286 | <reference > | |
287 | <![CDATA[1 9.Hirmerov a J, Suchy D, Madr T . Long-ter m drug int eraction o f warfarin with amio darone. Ca s Lek Cesk 2003 Jan 20;142(1): 39-42.]]> | |
288 | </referenc e> | |
289 | ||
290 | <reference > | |
291 | <![CDATA[2 0.Naganuma M, Shiga T, Nishika ta K, Tsuc hiya T, Ka sanuki H, Fujii E. R ole of des ethylamiod arone in t he anticoa gulant eff ect of con current am iodarone a nd warfari n therapy. J Cardiov asc Pharma col Ther 2 001 Oct; 6 (4):363-7. ]]> | |
292 | </referenc e> | |
293 | ||
294 | <reference > | |
295 | <![CDATA[2 1.Sanoski CA, Bauman JL. Clini cal observ ations wit h the amio darone/war farin inte raction: d osing rela tionships with long- term thera py. Chest 2002 Jan; 121(1):19- 23.]]> | |
296 | </referenc e> | |
297 | ||
298 | </referenc es> | |
299 | ||
300 | </professi onalMonogr aph> | |
301 | ||
302 | </drugDrug Check> | |
303 | ||
304 | </drugDrug Checks> | |
305 | ||
306 | </drugChec k> | |
307 | ||
308 | </Body> | |
309 | </PEPSResp onse> |
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