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Drug overview for PROTEOLIN (protein hydrolysate,milk/turmeric/blk pepper/pineapple ext):
Generic name: PROTEIN HYDROLYSATE,MILK/TURMERIC/BLK PEPPER/PINEAPPLE EXT
Drug class:
Therapeutic class: Alternative Therapy
No enhanced Introduction information available for this drug.
No enhanced Uses information available for this drug.
Generic name: PROTEIN HYDROLYSATE,MILK/TURMERIC/BLK PEPPER/PINEAPPLE EXT
Drug class:
Therapeutic class: Alternative Therapy
No enhanced Introduction information available for this drug.
No enhanced Uses information available for this drug.
DRUG IMAGES
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The following indications for PROTEOLIN (protein hydrolysate,milk/turmeric/blk pepper/pineapple ext) have been approved by the FDA:
Indications:
None.
Professional Synonyms:
None.
Indications:
None.
Professional Synonyms:
None.
The following dosing information is available for PROTEOLIN (protein hydrolysate,milk/turmeric/blk pepper/pineapple ext):
No enhanced Dosing information available for this drug.
No enhanced Administration information available for this drug.
No dosing information available.
No generic dosing information available.
The following drug interaction information is available for PROTEOLIN (protein hydrolysate,milk/turmeric/blk pepper/pineapple ext):
There are 0 contraindications.
There are 4 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Selected Chemotherapy Agents/Turmeric (Curcumin) SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Curcumin, the major component of turmeric, has been shown to decrease chemotherapy-induced apoptosis by inhibition of reactive oxygen species generation and blockade of the c-Jun NH2-terminal kinase pathway.(1) CLINICAL EFFECTS: Concurrent use of turmeric (curcumin) may decrease the effectiveness of some chemotherapy agents.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Patients receiving cytotoxic therapy for breast cancer should be excluded from curcumin-based chemotherapy.(1) It would be prudent to instruct patients to avoid or limit consumption of curcumin or turmeric. DISCUSSION: In vitro studies in MCF-7 cancer cell lines showed that curcumin decreased camptothecin-induced, doxorubicin-induced, and mechlorethamine-induced apoptosis. In vivo tests in mice xenograft models of human breast cancer, dietary curcumin decreased cyclophosphamide-induced tumor regression.(1) |
ADRIAMYCIN, CAELYX, CAMPTOSAR, CYCLOPHOSPHAMIDE, CYCLOPHOSPHAMIDE MONOHYDRATE, DOXIL, DOXORUBICIN HCL, DOXORUBICIN HCL LIPOSOME, FRINDOVYX, IRINOTECAN HCL, MECHLORETHAMINE HCL, ONIVYDE |
| Pazopanib/Selected Inhibitors of P-gp or BCRP SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Inhibitors of P-glycoprotein (P-gp) or BCRP may increase the absorption of pazopanib.(1) CLINICAL EFFECTS: The concurrent administration of pazopanib with an inhibitor of P-glycoprotein or BCRP may result in elevated levels of pazopanib and signs of toxicity.(1) PREDISPOSING FACTORS: The risk of QT prolongation or torsade de pointes may be increased in patients with cardiovascular disease (e.g. heart failure, myocardial infarction, history of torsade de pointes, congenital long QT syndrome), hypokalemia, hypomagnesemia, hypocalcemia, bradycardia, female gender, or advanced age.(2) Concurrent use of more than one drug known to cause QT prolongation or higher systemic concentrations of either QT prolonging drug are additional risk factors for torsade de pointes. Factors which may increase systemic drug concentrations include rapid infusion of an intravenous dose or impaired metabolism or elimination of the drug (e.g. coadministration with an agent which inhibits its metabolism or elimination, and/or renal/hepatic dysfunction).(2) PATIENT MANAGEMENT: The US manufacturer of pazopanib states concurrent use of P-gp inhibitors or BCRP inhibitors should be avoided.(1) Monitor patients for increased side effects from pazopanib. If concurrent therapy is warranted, consider obtaining serum calcium, magnesium, and potassium levels and monitoring ECG at baseline and at regular intervals. Correct any electrolyte abnormalities. Instruct patients to report any irregular heartbeat, dizziness, or fainting. DISCUSSION: Pazopanib is a substrate of P-gp and BCRP. Inhibitors of these transporters are expected to increase pazopanib levels.(1) BCRP inhibitors linked to this monograph include: asciminib, belumosudil, clopidogrel, cyclosporine, curcumin, darolutamide, eltrombopag, enasidenib, febuxostat, fostemsavir, grazoprevir, lazertinib, leflunomide, leniolisib, momelotinib, oteseconazole, pirtobrutinib, regorafenib, resmetirom, ritonavir, rolapitant, roxadustat, tafamidis, teriflunomide, tolvaptan, turmeric, and vadadustat.(1,3-5) P-glycoprotein inhibitors linked to this monograph include: asunaprevir, belumosudil, capmatinib, carvedilol, cyclosporine, danicopan, daridorexant, diltiazem, flibanserin, fostamatinib, ginseng, glecaprevir/pibrentasvir, isavuconazonium, ivacaftor, ledipasvir, neratinib, sofosbuvir/velpatasvir/voxilaprevir, tepotinib, tezacaftor, ticagrelor, valbenazine, verapamil, vimseltinib, and voclosporin.(3,4) |
PAZOPANIB HCL, VOTRIENT |
| Cladribine/Selected Inhibitors of BCRP SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Inhibitors of BCRP may increase the absorption of cladribine.(1-2) CLINICAL EFFECTS: The concurrent administration of cladribine with an inhibitor of BCRP may result in elevated levels of cladribine and signs of toxicity.(1-2) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The manufacturer of cladribine states concurrent use of BCRP inhibitors should be avoided during the 4- to 5-day cladribine treatment.(1-2) Selection of an alternative concurrent medication with no or minimal transporter inhibiting proprieties should be considered. If this is not possible, dose reduction to the minimum mandatory dose of the BCRP inhibitor, separation in timing of administration, and careful patient monitoring is recommended.(1-2) Monitor for signs of hematologic toxicity. Lymphocyte counts should be monitored. DISCUSSION: Cladribine is a substrate of BCRP. Inhibitors of this transporter are expected to increase cladribine levels.(1-2) BCRP inhibitors linked to this monograph include: capmatinib, clopidogrel, curcumin, danicopan, darolutamide, dasabuvir, eltrombopag, enasidenib, febuxostat, fostamatinib, fostemsavir, glecaprevir/pibrentasvir, grazoprevir, lazertinib, oteseconazole, pacritinib, pantoprazole, paritaprevir, regorafenib, resmetirom, ritonavir, rolapitant, roxadustat, selpercatinib, sofosbuvir/velpatasvir/voxilaprevir, tafamidis, ticagrelor, tolvaptan, turmeric, and vadadustat.(1-4) |
CLADRIBINE, MAVENCLAD |
| Topotecan/BCRP Inhibitors SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Inhibitors of the BCRP transporter may increase the intestinal absorption and hepatic uptake of topotecan.(1) CLINICAL EFFECTS: The concurrent administration of topotecan with an inhibitor of BCRP may result in elevated levels of topotecan and signs of toxicity. These signs may include but are not limited to anemia, diarrhea, and thrombocytopenia.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of topotecan states that the use of topotecan and BCRP inhibitors should be avoided. If concurrent use is warranted, carefully monitor patients for adverse effects.(1) DISCUSSION: In clinical studies, the combined use of elacridar (100 mg to 1000 mg), a BCRP and P-gp inhibitor, increased the area-under-curve (AUC) of topotecan approximately 2.5-fold.(1) BCRP inhibitors linked to this monograph include: capmatinib, clopidogrel, curcumin, danicopan, dasabuvir, elbasvir, enasidenib, febuxostat, fostamatinib, fostemsavir, glecaprevir, grazoprevir, lazertinib, oteseconazole, pacritinib, pantoprazole, paritaprevir, pibrentasvir, pirtobrutinib, regorafenib, resmetirom, ritonavir, roxadustat, tafamidis, ticagrelor, tolvaptan, turmeric, vadadustat, velpatasvir, and voxilaprevir.(2,3) |
HYCAMTIN, TOPOTECAN HCL |
There are 2 moderate interactions.
The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.
| Drug Interaction | Drug Names |
|---|---|
| Ubrogepant/P-gp or BCRP Inhibitors SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Inhibitors of P-glycoprotein (P-gp) or BCRP may increase the absorption of ubrogepant.(1) CLINICAL EFFECTS: The concurrent administration of ubrogepant with an inhibitor of P-glycoprotein or BCRP may result in elevated levels of ubrogepant.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The manufacturer recommends a dosage adjustment of ubrogepant when coadministered with P-gp or BCRP inhibitors. The dose of ubrogepant should not exceed 50 mg for initial dose. If a second dose of ubrogepant is needed, the dose should not exceed 50 mg.(1) The manufacturer of vimseltinib states concurrent use with P-gp substrates should be avoided. If concurrent use cannot be avoided, take vimseltinib at least 4 hours prior to ubrogepant.(3) DISCUSSION: Ubrogepant is a substrate of P-gp and BCRP transporters. Use of P-gp or BCRP inhibitors may increase the exposure of ubrogepant. Clinical drug interaction studies with inhibitors of these transporters were not conducted. The US manufacturer of ubrogepant recommends dose adjustment if ubrogepant is coadministered with P-gp or BCRP inhibitors.(1) BCRP inhibitors linked to this monograph include: belumosudil, clopidogrel, curcumin, eltrombopag, febuxostat, fostemsavir, leniolisib, momelotinib, oteseconazole, pantoprazole, regorafenib, resmetirom, ritonavir, rolapitant, roxadustat, tafamidis, oral tedizolid, turmeric, and vadadustat.(2-5) P-glycoprotein inhibitors linked to this monograph include: asunaprevir, belumosudil, carvedilol, danicopan, daridorexant, neratinib, osimertinib, propafenone, quinidine, sofosbuvir/velpatasvir/voxilaprevir, tepotinib, tezacaftor, valbenazine, vimseltinib, and voclosporin.(2-5) |
UBRELVY |
| Atorvastatin; Rosuvastatin/Selected BCRP Inhibitors SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Atorvastatin and rosuvastatin are both substrates of the BCRP transporter.(1-3) Inhibitors of this transporter may increase intestinal absorption and hepatic uptake of BCRP substrates atorvastatin and rosuvastatin.(1-9) CLINICAL EFFECTS: Simultaneous use of BCRP inhibitors may result in increased levels and side effects from atorvastatin and rosuvastatin, including rhabdomyolysis.(1,3,5) PREDISPOSING FACTORS: The risk for myopathy or rhabdomyolysis may be greater in patients 65 years and older, inadequately treated hypothyroidism, renal impairment, carnitine deficiency, malignant hyperthermia, or in patients with a history of myopathy or rhabdomyolysis. Patients with a SLCO1B1 polymorphism that leads to decreased function of the hepatic uptake transporter OATP1B1 may have increased statin concentrations and be predisposed to myopathy or rhabdomyolysis. Patients on rosuvastatin with ABCG2 polymorphisms leading to decreased or poor BCRP transporter function may have increased rosuvastatin concentrations and risk of myopathy. PATIENT MANAGEMENT: Concurrent use of atorvastatin or rosuvastatin with BCRP inhibitors may result in increased risk of side effects associated with atorvastatin and rosuvastatin. If concurrent therapy is warranted, close monitoring would be prudent for statin related side effects including rhabdomyolysis. The Canadian manufacturer of clopidogrel states that the dose of rosuvastatin should not exceed 20 mg daily when used concomitantly with clopidogrel.(6) There is no recommendation for rosuvastatin dose adjustments from the Australian and US manufacturers of clopidogrel.(7,8) The Australian manufacturer of rosuvastatin states that the starting dose of rosuvastatin should not exceed 5 mg daily when used with agents that increase rosuvastatin exposure by 2-fold or more (e.g., clopidogrel, lopinavir-ritonavir, roxadustat). The maximum daily dose should be adjusted so that the expected rosuvastatin exposure does not exceed that obtained with the usual maximum daily dose.(9) Educate the patient of signs and symptoms of rhabdomyolysis. DISCUSSION: Atorvastatin and rosuvastatin are both BCRP substrates.(1-3) In a clinical study of 20 patients with stable coronary heart disease, single-dose clopidogrel 300 mg (a BCRP inhibitor) increased the area-under-curve (AUC) and maximum concentration (Cmax) of rosuvastatin by 2-fold and 1.3-fold, respectively. Multiple doses of clopidogrel 75 mg daily for 7 days increased rosuvastatin AUC by 1.4-fold but did not affect the Cmax.(5) In a pharmacokinetic study, concomitant use of lazertinib increased rosuvastatin Cmax by 2.2-fold and AUC by 2-fold.(4) BCRP inhibitors linked to this monograph include: clopidogrel, curcumin, encorafenib, lazertinib, pantoprazole, ritonavir, rolapitant, roxadustat, tolvaptan, and turmeric.(3-10) |
AMLODIPINE-ATORVASTATIN, ATORVALIQ, ATORVASTATIN CALCIUM, CADUET, CRESTOR, EZALLOR SPRINKLE, LIPITOR, ROSUVASTATIN CALCIUM, ROSUVASTATIN-EZETIMIBE, ROSZET |
The following contraindication information is available for PROTEOLIN (protein hydrolysate,milk/turmeric/blk pepper/pineapple ext):
Drug contraindication overview.
No enhanced Contraindications information available for this drug.
No enhanced Contraindications information available for this drug.
There are 2 contraindications.
Absolute contraindication.
| Contraindication List |
|---|
| Biliary calculus |
| Gallbladder disease |
There are 0 severe contraindications.
There are 2 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Disease of liver |
| Gastroesophageal reflux disease |
The following adverse reaction information is available for PROTEOLIN (protein hydrolysate,milk/turmeric/blk pepper/pineapple ext):
Adverse reaction overview.
No enhanced Common Adverse Effects information available for this drug.
No enhanced Common Adverse Effects information available for this drug.
There are 1 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. | None. |
| Rare/Very Rare |
|---|
|
Drug-induced hepatitis |
There are 13 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. | None. |
| Rare/Very Rare |
|---|
|
Abdominal distension Abdominal pain with cramps Constipation Diarrhea Dyspepsia Flatulence Gastritis Gastroesophageal reflux disease Nausea Pruritus of skin Tongue discoloration Urticaria Vomiting |
The following precautions are available for PROTEOLIN (protein hydrolysate,milk/turmeric/blk pepper/pineapple ext):
No enhanced Pediatric Use information available for this drug.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
No enhanced Pregnancy information available for this drug.
No enhanced Lactation information available for this drug.
No enhanced Geriatric Use information available for this drug.
The following prioritized warning is available for PROTEOLIN (protein hydrolysate,milk/turmeric/blk pepper/pineapple ext):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for PROTEOLIN (protein hydrolysate,milk/turmeric/blk pepper/pineapple ext)'s list of indications:
No ICD codes found for this drug.
No ICD codes found for this drug.
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