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Mapap PM 与 Tamoxifen Citrate

Mapap PM 与 Tamoxifen Citrate互相作用以及同时服用的可能性。

检测结果:

Mapap PM <> Tamoxifen Citrate

现实性: 16.06.2022 评论家: 医学副博士Shkutko P.M., in

在该服务的官方手册中，已注明相关研究结果统计规定的互相作用。该互相作用或对患者健康引起不良后果，或起到良好效果。具体联合用药问题，需遵从医嘱。

用户:

当使用定期或连续延长的期间，苯海拉明可以降低效能的他在治疗乳腺癌。谈谈你的医生如果你有任何疑问或关切的问题。你的医生可以规定替代品，不进行互动。重要的是要告诉你的医生关于所有其他药物的使用，包括维生素和草药。不停止使用任何药物，没有第一个说你的医生。

医界专家:

一般避免：慢性共同给予的有力度或中度CYP450 2D6抑制剂，包括某些抗抑郁药可能降低效率的他. 拟议的机制是抑制苯氧物活化通过CYP450 2D6到endoxifen(4-羟基-N-desmethyltamoxifen)，活跃的代谢物可能是负责很多他的抗雌激素活性。这是一致的研究报告贫穷的临床结果(例如，增加乳腺癌症复发；较短的复发的时期；降低利率的事件无生存)和减少病/严重性的热潮在治疗的患者与他人有遗传多态性的CYP450 2D6导致减少或者不存在的酶的活动。一个类似的关系已经观察到之间的endoxifen曝光和改建在CYP450 2D6代谢的状态，是否由于CYP450 2D6遗传变异或使用CYP450 2D6抑制剂，例如奎尼丁或SSRI类抗抑郁药。在一项研究的12名患者接受他辅助治疗，意味着等离子浓度的endoxifen下降了超过50%之后四周内帕罗西汀10毫克/天潮热的效果是显而易见的，主要是在患者进行的野型的基因型，用于CYP450 2D6(即广泛的代谢者). 在体外，奎尼丁减少转换到endoxifen通过的79%。潜在的临床影响的这种相互作用的报告中回顾分析的近1 300名女性乳腺癌的患者是新规定他之间2003年和2005年进行了监测，用于在至少两年(平均为2.7年)。妇女使用一种中度到有效的CYP450 2D6抑制剂(n=353)期间，他疗法已经两年乳腺癌的再次发生率为13.9%，相比7.5%，对于那些不采取任何CYP450 2D6抑制剂(n=945). 平均持续时间伴随他和CYP450 2D6抑制剂的使用为340日。在一个子集，分析的病人把他带SSRI类抗抑郁、乳腺癌症复发率16%的报告213妇女使用氟西汀，帕罗西汀，或者舍曲林--Ssri被认为是中度到有效的抑制剂的CYP450 2D6. 这个比率是2.2倍，妇女把他没有CYP450 2D6抑制剂。与此相比，乳腺癌症复发率是8.8％用于137妇女使用酞普兰,依他普仑，或沙明，这不是统计上不同于控制。早，小进行研究的一组丹麦研究人员还报告说没有减少他有效协会与游离或酞普兰使用长达五年。重要的是要注意，不是所有的研究发现之间的关联CYP450 2D6活动和他的临床效果。事实上，一对夫妇的研究，即使报告的减少的风险再次发生在患者与他人有一个共同的遗传变异的CYP450 2D6. 调查表明，存在差异可能是由于差异的研究的设计，包括样品大小不同的基因模型，用于评估的表型，及分层的影响。

管理：根据现有数据，接受治疗的患者与他应该避免长期使用的有效CYP450 2D6抑制剂，例如氟西汀，帕罗西汀，奎尼丁只要有可能，最好也适度的抑制剂，如安非他酮、洛西汀，并舍曲林。如果一种抗抑郁药需要治疗期间他、代理人诸如去甲文拉法辛,沙明、米那普仑、levomilnacipran,米氮平、和文拉法可认为，由于他们有轻度至没有影响CYP450 2D6. 或者，香酶抑制剂，如那曲，依西美坦和唑可能是合适的替代物为他，在某些特定患者。或者，香酶抑制剂，如那曲，依西美坦和唑可能是合适的替代物为他，在某些特定患者。

来源

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Mapap PM

非专利名称: acetaminophen / diphenhydramine

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