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Drug Interactions between alvimopan and Tramal

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

traMADol alvimopan

Applies to: Tramal (tramadol) and alvimopan

CONTRAINDICATED: Recent exposure to opioids can increase the sensitivity to mu opioid receptor antagonists.

MANAGEMENT: The use of alvimopan is contraindicated in patients who have received therapeutic doses of opioids for more than 7 consecutive days immediately prior to alvimopan administration. Caution is advised in patients who have received more than 3 doses of an opioid within the week prior to surgery, as these patients were not studied in the postoperative ileus clinical trials. Patients with recent exposure to opioids should be monitored for increased adverse effects such as abdominal pain, nausea and vomiting, and diarrhea.

References

  1. "Product Information. Entereg (alvimopan)." GlaxoSmithKline (2008):

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Drug and food interactions

Moderate

traMADol food

Applies to: Tramal (tramadol)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
  3. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  4. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
View all 4 references

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Minor

alvimopan food

Applies to: alvimopan

Coadministration with a high-fat meal may decrease the rate and extent of alvimopan absorption. According to the product labeling, alvimopan peak plasma concentration (Cmax) and systemic exposure (AUC) were decreased by approximately 38% and 21%, respectively, and the time to reach peak plasma concentration (Tmax) was prolonged by approximately 1 hour when taken with a high-fat meal. The clinical significance is unknown. In postoperative ileus clinical trials, the preoperative dose of alvimopan was administered in a fasting state, and subsequent doses were given without regard to meals.

References

  1. "Product Information. Entereg (alvimopan)." GlaxoSmithKline (2008):

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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