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Drug Interactions between Brisdelle and pravastatin

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

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Interactions between your drugs

Moderate

pravastatin PARoxetine

Applies to: pravastatin and Brisdelle (paroxetine)

MONITOR: Coadministration of paroxetine and pravastatin has been reported to increase blood glucose in some studies. The mechanism of interaction is unclear. In one study using data from three electronic medical record (EMR) systems, a group of investigators retrospectively evaluated 104 patients with diabetes and 135 without diabetes who had received the combination and found that mean random blood glucose levels increased significantly from baseline after initiating the combination. The average increase was 19 mg/dL overall and 48 mg/dL in patients with diabetes. Similar increases were not observed in patients receiving either drug alone or other combinations of statin and selective serotonin reuptake inhibitor (SSRI). Likewise, another group of investigators using data from a different EMR system reported an increase of 19 mg/dL in mean glucose level from baseline in patients receiving the combination. In a third retrospective database study, investigators found no difference in random glucose, fasting glucose, and glycosylated hemoglobin mean values between 65 patients who were prescribed paroxetine and pravastatin and 2084 patients who were prescribed other statin and SSRI combinations after adjusting for the covariates of age, gender, body mass index, and body weight. However, no comparisons with baseline values were performed.

MANAGEMENT: Caution is advisable during concomitant use of paroxetine and pravastatin, particularly in patients with diabetes. More frequent monitoring of blood glucose should be considered.

References

  1. Tatonetti NP, Denny JC, Murphy SN, et al. "Detecting drug interactions from adverse-event reports: interaction between paroxetine and pravastatin increases blood glucose levels." Clin Pharmacol Ther 90 (2011): 133-42
  2. Andrade C "Selective serotonin reuptake inhibitor drug interactions in patients receiving statins." J Clin Psychiatry 75 (2014): e95-9
  3. An L, Ravindran PP, Renukunta S, Denduluri S "Co-medication of pravastatin and paroxetine-a categorical study." J Clin Pharmacol 53 (2013): 1212-9
  4. Orrico KB, Huynh MH, Olson CW "A comparison of glucose measures in patients receiving concomitant paroxetine and pravastatin to other SSRI/statin combinations: A retrospective, observational database review." Ann Pharmacother 48 (2014): 1172-6
  5. Li F, Zhang M, et al. "Co-administration of paroxetine and pravastatin causes deregulation of glucose homeostasis in diabetic rats via enhanced paroxetine exposure." Acta Pharmacol Sin 35 (2014): 792-805
View all 5 references

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Drug and food interactions

Moderate

PARoxetine food

Applies to: Brisdelle (paroxetine)

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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Moderate

pravastatin food

Applies to: pravastatin

MONITOR: Concomitant use of statin medication with substantial quantities of alcohol may increase the risk of hepatic injury. Transient increases in serum transaminases have been reported with statin use and while these increases generally resolve or improve with continued therapy or a brief interruption in therapy, there have been rare postmarketing reports of fatal and non-fatal hepatic failure in patients taking statins. Patients who consume substantial quantities of alcohol and/or have a history of liver disease may be at increased risk for hepatic injury. Active liver disease or unexplained transaminase elevations are contraindications to statin use.

MANAGEMENT: Patients should be counseled to avoid substantial quantities of alcohol in combination with statin medications and clinicians should be aware of the increased risk for hepatotoxicity in these patients.

References

  1. "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb PROD (2001):
  2. "Product Information. Zocor (simvastatin)." Merck & Co., Inc PROD (2001):
  3. "Product Information. Lescol (fluvastatin)." Novartis Pharmaceuticals PROD (2001):
  4. "Product Information. Lipitor (atorvastatin)." Parke-Davis PROD (2001):
  5. "Product Information. Altocor (lovastatin)." Andrx Pharmaceuticals (2002):
  6. "Product Information. Crestor (rosuvastatin)." AstraZeneca Pharma Inc (2003):
  7. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  8. Cerner Multum, Inc. "Australian Product Information." O 0
  9. "Product Information. Livalo (pitavastatin)." Kowa Pharmaceuticals America (formerly ProEthic) (2010):
View all 9 references

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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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