Drug Synergy

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Are there references in Rosners book? Or are there references about

Benicar potentiating other drugs? Or are these 'observations'?

Makes a huge difference to me.. especially if $$ is being made by the

terms use..

Here's some FACTS:

BENICAR Drug Interactions

No significant drug interactions were reported in studies in which

olmesartan medoxomil was co-administered with digoxin or warfarin in

healthy volunteers. The bioavailability of olmesartan was not

significantly altered by the co-administration of antacids [Al(OH)3/Mg

(OH)2]. Olmesartan medoxomil is not metabolized by the cytochrome

P450 system and has no effects on P450 enzymes; thus, interactions

with drugs that inhibit, induce or are metabolized by those enzymes

are not expected.

www.fda.gov/MEDWATCH/SAFETY/2004/nov_PI/Benicar_Tab_PI.pdf

DRUG SYNERGY:

I've posted this before.. but this is what I'm talking about the

word 'synergy' is used - synergistic drugs are eqal to more than what

they are when used singly

REFERENCE ABSTRACT

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=89536

Antimicrob Agents Chemother. 1999 November; 43(11): 2635–2641.

Copyright © 1999, American Society for Microbiology

Synergistic Fungistatic Effects of Lactoferrin in Combination with

Antifungal Drugs against Clinical Candida Isolates

M. E. Kuipers,1* H. G. de Vries,2 M. C. Eikelboom,1 D. K. F. Meijer,1

and P. J. Swart1†

Section of Pharmacokinetics and Drug Delivery, Groningen University

Institute for Drug Studies, University Centre for Pharmacy, 9713 AV

Groningen,1 and Section of Medical Microbiology, University Hospital

Groningen, 9713 GZ Groningen,2 The Netherlands

Because of the rising incidence of failures in the treatment of

oropharyngeal candidosis in the case of severely immunosuppressed

patients (mostly human immunodeficiency virus [HIV]-infected

patients), there is need for the development of new, more effective

agents and/or compounds that support the activity of the common

antifungal agents. Since lactoferrin is one of the nonspecific host

defense factors present in saliva that exhibit antifungal activity,

we studied the antifungal effects of human, bovine, and iron-depleted

lactoferrin in combination with fluconazole, amphotericin B, and 5-

fluorocytosine in vitro against clinical isolates of Candida species.

Distinct antifungal activities of lactoferrin were observed against

clinical isolates of Candida. The MICs generally were determined to

be in the range of 0.5 to 100 mg · ml & #8722;1.

Interestingly, in the combination experiments we observed pronounced

cooperative activity against the growth of Candida by using

lactoferrin and the three antifungals tested. Only in a limited

concentration range was minor antagonism detected.

The use of lactoferrin and fluconazole appeared to be the most

successful combination. Significant reductions in the minimal

effective concentrations of fluconazole were found when it was

combined with a relatively low lactoferrin concentration (1 mg/ml).

Such combinations still resulted in complete growth inhibition, while

synergy of up to 50% against several Candida species was observed. It

is concluded that the combined use of lactoferrin and antifungals

against severe infections with Candida is an attractive therapeutic

option. Since fluconazole-resistant Candida species have frequently

been reported, especially in HIV-infected patients, the addition of

lactoferrin to the existing fluconazole therapy could postpone the

occurrence of species resistance against fluconazole. Clinical

studies to further elucidate the potential utility of this

combination therapy have been initiated.

Drug InteractionsNo significant drug interactions were reported in

studies in which olmesartan medoxomil was co-administered with

digoxin or warfarin in healthy volunteers. The bioavailability of

olmesartan was not significantly altered by the co-administration of

antacids [Al(OH)3/Mg(OH)2]. Olmesartan medoxomil is not metabolized

by the cytochrome P450 system and has no effects on P450 enzymes;

thus, interactions with drugs that inhibit, induce or are metabolized

by those enzymes are not expected.