Drug Interactions between darunavir and ubrogepant
This report displays the potential drug interactions for the following 2 drugs:
- darunavir
- ubrogepant
Interactions between your drugs
darunavir ubrogepant
Applies to: darunavir and ubrogepant
ADJUST DOSE: Coadministration with moderate or weak inhibitors of CYP450 3A4 may increase the plasma concentrations of ubrogepant, which is primarily metabolized by the isoenzyme. When ubrogepant was administered with the moderate CYP450 3A4 inhibitor verapamil during in vivo studies, ubrogepant peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 2.8- and 3.5-fold, respectively. Dedicated drug interaction studies have not been conducted to assess concomitant use of ubrogepant with weak CYP450 3A4 inhibitors. Ubrogepant exposure is not expected to increase by more than 2-fold when used with weak CYP450 3A4 inhibitors, per a conservative prediction from the manufacturer.
MANAGEMENT: The manufacturer recommends an initial ubrogepant dose of 50 mg when coadministered with moderate or weak CYP450 3A4 inhibitors. If needed, a second ubrogepant dose should be avoided within 24 hours of the initial dose when used with moderate CYP450 3A4 inhibitors. When used with weak CYP450 3A4 inhibitors, a second 50 mg dose of ubrogepant may be administered at least 2 hours after the initial dose, if needed.
References
- (2019) "Product Information. Ubrelvy (ubrogepant)." Allergan Inc
Drug and food interactions
darunavir food
Applies to: darunavir
ADJUST DOSING INTERVAL: Food enhances the absorption and oral bioavailability of darunavir administered in combination with low-dose ritonavir. The mechanism is unknown. When administered with food, the peak plasma concentration (Cmax) and area under the plasma concentration-time curve (AUC) of darunavir were approximately 30% higher than when administered in the fasting state. Darunavir exposure was similar for the range of meals studied. The total caloric content of the various meals evaluated ranged from 240 Kcal (12 grams fat) to 928 Kcal (56 grams fat).
MANAGEMENT: To ensure maximal oral absorption, darunavir coadministered with ritonavir should be taken with food. The type of food is not important.
References
- (2006) "Product Information. Prezista (darunavir)." Ortho Biotech Inc
ubrogepant food
Applies to: ubrogepant
ADJUST DOSE: Grapefruit and grapefruit juice may increase the plasma concentrations of ubrogepant. 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 but has been reported for other CYP450 3A4 inhibitors. When ubrogepant was administered with the moderate CYP450 3A4 inhibitor verapamil during in vivo studies, ubrogepant peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 2.8- and 3.5-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.
When administered with a high-fat meal, ubrogepant time to maximum plasma concentration (Tmax) was delayed by 2 hours, which resulted in a 22% decrease in Cmax and no change in AUC. Ubrogepant was administered without regard to food in clinical efficacy studies.
MANAGEMENT: Ubrogepant may be administered with or without food. Per the manufacturer, when coadministered with grapefruit or grapefruit juice, the initial ubrogepant dose should be 50 mg, and if needed, a second ubrogepant dose should be avoided within 24 hours of the initial dose.
References
- (2019) "Product Information. Ubrelvy (ubrogepant)." Allergan Inc
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
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
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