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Drug Interactions between chloroquine and risdiplam

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

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Interactions between your drugs

Moderate

chloroquine risdiplam

Applies to: chloroquine and risdiplam

MONITOR: Theoretical concerns exist that oculotoxic effects of risdiplam, observed in monkeys, may be additive with those of other drugs that are associated with retinotoxicity. Chronic treatment of monkeys with risdiplam showed photoreceptor degeneration starting in the periphery of the retina. Upon cessation of treatment, the effects on the retinogram were partially reversible but the retinal degeneration, with peripheral photoreceptor loss, was irreversible. A no-effect dose for the retinal findings (1.5 mg/kg/day) in monkeys was associated with plasma exposures (AUC) like that in humans at the maximum recommended human dose (MRHD) of 5 mg. However, the potential for synergistic effects of concomitant administration of risdiplam with retinotoxic drugs has not been studied.

MANAGEMENT: Some authorities (AU) recommend caution when risdiplam is used concomitantly with known or suspected retinotoxic drugs. These drugs may include infigratinib, selumetinib, cobimetinib, vigabatrin, chloroquine, hydroxychloroquine, thioridazine and deferoxamine.

References

  1. (2002) "Product Information. Aralen (chloroquine)." Sanofi Winthrop Pharmaceuticals
  2. (2001) "Product Information. Desferal (deferoxamine)." Novartis Pharmaceuticals
  3. (2022) "Product Information. Plaquenil (hydroxychloroquine)." Apothecon Inc
  4. (2001) "Product Information. Mellaril (thioridazine)." Sandoz Pharmaceuticals Corporation
  5. (2005) "Product Information. Chloroquine Phosphate (chloroquine)." West Ward Pharmaceutical Corporation
  6. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  7. Cerner Multum, Inc. "Australian Product Information."
  8. (2009) "Product Information. Sabril (vigabatrin)." Lundbeck Inc
  9. (2015) "Product Information. Deferoxamine Mesylate (deferoxamine)." Hospira Inc
  10. Cerner Multum, Inc (2015) "ANVISA Bulário Eletrônico."
  11. (2015) "Product Information. Cotellic (cobimetinib)." Genentech
  12. (2017) "Product Information. Hydroxychloroquine Sulfate (hydroxychloroquine)." Prasco Laboratories
  13. (2019) "Product Information. Thioridazine Hydrochloride (thioridazine)." Mylan Institutional (formerly UDL Laboratories)
  14. (2020) "Product Information. Koselugo (selumetinib)." Astra-Zeneca Pharmaceuticals
  15. (2021) "Product Information. Truseltiq (infigratinib)." QED Therapeutics Inc
View all 15 references

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Drug and food interactions

Moderate

chloroquine food

Applies to: chloroquine

GENERALLY AVOID: Theoretically, grapefruit and grapefruit juice may increase the plasma concentrations of hydroxychloroquine or chloroquine and the risk of toxicities such as QT interval prolongation and ventricular arrhythmias. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall induced by certain compounds present in grapefruit. Following coadministration with cimetidine, a weak to moderate CYP450 3A4 inhibitor, a 2-fold increase in chloroquine exposure occurred. Since chloroquine and hydroxychloroquine have similar structures and metabolic elimination pathways, a similar interaction may be observed with hydroxychloroquine. 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. Pharmacokinetic interactions involving grapefruit juice are also subject to a high degree of interpatient variability, thus the extent to which a given patient may be affected is difficult to predict.

MANAGEMENT: Although clinical data are lacking, it may be advisable to avoid the consumption of grapefruit, grapefruit juice, and any supplement containing grapefruit extract during hydroxychloroquine or chloroquine therapy.

References

  1. Cerner Multum, Inc. "Australian Product Information."

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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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