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Drug Interactions between Bel-Phen-Ergot and capivasertib

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

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Interactions between your drugs

Major

PHENobarbital capivasertib

Applies to: Bel-Phen-Ergot (belladonna / ergotamine / phenobarbital) and capivasertib

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration with moderate to potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations and pharmacologic effects of capivasertib. The proposed mechanism is accelerated clearance of capivasertib due to induction of the CYP450 3A4 isoenzyme, which is the primary route of elimination of capivasertib. Based on clinical studies and model-informed approaches, concomitant use with the potent CYP450 3A4 inducer rifampin is predicted to decrease capivasertib systemic exposure (AUC) by 70% and peak plasma concentration (Cmax) by 60%. Coadministration with the moderate CYP450 3A4 inducer efavirenz, is predicted to decrease capivasertib AUC by 60% and Cmax by 50%. Reduced therapeutic efficacy of capivasertib may occur.

MANAGEMENT: The use of capivasertib with moderate to potent CYP450 3A4 inducers should generally be avoided.

References

  1. "Product Information. Truqap (capivasertib)." Astra-Zeneca Pharmaceuticals (2023):
Moderate

ergotamine PHENobarbital

Applies to: Bel-Phen-Ergot (belladonna / ergotamine / phenobarbital) and Bel-Phen-Ergot (belladonna / ergotamine / phenobarbital)

PHENobarbital may reduce the blood levels and effects of ergotamine. Contact your doctor if your symptoms worsen or your condition changes during treatment with these medications. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

ergotamine capivasertib

Applies to: Bel-Phen-Ergot (belladonna / ergotamine / phenobarbital) and capivasertib

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with capivasertib may increase the plasma concentrations of drugs that are substrates of CYP450 3A4 via inhibition of the isoenzyme. Based on clinical studies and model-informed approaches, concomitant use of capivasertib and midazolam, a sensitive CYP450 3A4 substrate, increased midazolam systemic exposure (AUC) by 1.8-fold on day 4 and by 1.2-fold on day 7 of capivasertib treatment.

MANAGEMENT: Caution is advised if capivasertib is coadministered with CYP450 3A4 substrates, particularly sensitive substrates, or those with a narrow therapeutic range. Clinical and laboratory monitoring may be appropriate whenever capivasertib is added to or withdrawn from therapy. The prescribing information for concomitant medications may be consulted to assess the benefits versus risks of coadministration and for any dosage adjustments that may be required.

References

  1. "Product Information. Truqap (capivasertib)." Astra-Zeneca Pharmaceuticals (2023):

Drug and food interactions

Major

capivasertib food

Applies to: capivasertib

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of capivasertib, which is primarily metabolized by CYP450 3A4. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Inhibition of hepatic CYP450 3A4 may also contribute. The interaction has not been studied with grapefruit juice but has been studied with other CYP450 3A4 inhibitors. Based on clinical studies and model-informed approaches, concomitant use with the potent CYP450 3A4 inhibitor itraconazole is predicted to increase capivasertib systemic exposure (AUC) by up to 1.7-fold and peak plasma concentration (Cmax) by up to 1.4-fold. Coadministration with the moderate CYP450 3A4 inhibitors erythromycin and verapamil is predicted to increase the AUC and Cmax of capivasertib by up to 1.5-fold 1.3-fold, respectively. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition. Increased exposure to capivasertib may increase the risk of adverse effects such as diarrhea, cutaneous adverse reactions, decreased lymphocytes, decreased hemoglobin, hyperglycemia, nausea, and fatigue.

MANAGEMENT: It may be advisable for patients to avoid the consumption of grapefruit, grapefruit juice, or supplements that contain grapefruit during treatment with capivasertib.

References

  1. "Product Information. Truqap (capivasertib)." Astra-Zeneca Pharmaceuticals (2023):
Major

PHENobarbital food

Applies to: Bel-Phen-Ergot (belladonna / ergotamine / phenobarbital)

Ask your doctor before using PHENobarbital together with ethanol, this can add to dizziness, drowsiness and other side effects of PHENobarbital. Be careful if you drive or do activities that require you to be awake and alert. Talk with your doctor before using any medications together, or drinking alcohol with PHENobarbital. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

ergotamine food

Applies to: Bel-Phen-Ergot (belladonna / ergotamine / phenobarbital)

Grapefruit juice may increase the blood levels of certain medications such as ergotamine. You may want to limit your consumption of grapefruit and grapefruit juice during treatment with ergotamine. However, if you have been regularly consuming grapefruit or grapefruit juice with the medication, then it is advisable for you to talk with your doctor before changing the amounts of these products in your diet, as this may alter the effects of your medication. Contact your doctor if your condition changes or you experience increased side effects. Orange juice is not expected to interact.

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Moderate

belladonna food

Applies to: Bel-Phen-Ergot (belladonna / ergotamine / phenobarbital)

Ask your doctor before using belladonna together with ethanol. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking belladonna. You should be warned not to exceed recommended dosages and to avoid activities requiring mental alertness. If your doctor prescribes these medications together, you may need a dose adjustment to safely take this combination. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

ergotamine food

Applies to: Bel-Phen-Ergot (belladonna / ergotamine / phenobarbital)

Nicotine may increase the effects of ergotamine in narrowing the blood vessels and decreasing blood flow. A severe decrease in blood flow to the brain and other parts of the body can lead to dangerous side effects. Contact your doctor immediately if you experience coldness, paleness, discoloration, numbness, tingling, or pain in your hands or feet; muscle pain or weakness; severe or worsening headache; blurred vision; severe abdominal pain; chest pain; or shortness of breath while using these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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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.


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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.