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Drug Interactions between atazanavir and lamotrigine

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

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Interactions between your drugs

Moderate

lamoTRIgine atazanavir

Applies to: lamotrigine and atazanavir

MONITOR: The concomitant use of lamotrigine and atazanavir-ritonavir may reduce plasma concentrations of lamotrigine. The mechanism is induction of glucuronidation. In a study, the use of atazanavir-ritonavir (300 mg/100 mg) for 9 days decreased the plasma AUC and Cmax of a single 100 mg dose of lamotrigine by 32% and 6%, respectively.

MANAGEMENT: No dose adjustments are required when lamotrigine is added to an existing regimen of atazanavir-ritonavir. However, if the regimen includes a maintenance dose of lamotrigine and no other glucuronidation inducers, a dosage increase may be required when atazanavir-ritonavir is added to the regimen, based on clinical response and plasma levels. A dosage decrease may be required upon discontinuation of atazanavir-ritonavir. Monitoring of plasma lamotrigine levels is recommended before and after atazanavir-ritonavir is initiated or discontinued. The manufacturer's labeling should be consulted for the appropriate dosage regimen.

References

  1. (2001) "Product Information. Lamictal (lamotrigine)." Glaxo Wellcome
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Cerner Multum, Inc. "Australian Product Information."

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Drug and food interactions

Moderate

lamoTRIgine food

Applies to: lamotrigine

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

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Moderate

atazanavir food

Applies to: atazanavir

ADJUST DOSING INTERVAL: Administration of atazanavir with food enhances oral bioavailability and reduces pharmacokinetic variability. According to the manufacturer, administration with a light meal increased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of a single 400 mg dose of atazanavir by 57% and 70%, respectively, relative to the fasting state. Administration with a high-fat meal resulted in a mean increase of 35% in atazanavir AUC and no change in Cmax compared to fasting. The coefficient of variation of AUC and Cmax decreased by approximately one-half when given with either a light or high-fat meal compared to the fasting state.

MANAGEMENT: To ensure maximal oral absorption, atazanavir should be administered with or immediately after a meal.

References

  1. (2003) "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb

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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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