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Drug Interactions between deferasirox and oliceridine

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

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Interactions between your drugs

Moderate

deferasirox oliceridine

Applies to: deferasirox and oliceridine

MONITOR: Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of opioids that are metabolized by the isoenzyme such as butorphanol, fentanyl, hydrocodone, methadone, and oxycodone. Reduced efficacy or withdrawal symptoms may occur in patients maintained on their narcotic pain regimen following the addition of a CYP450 3A4 inducer. Conversely, discontinuation of the inducer may increase opioid plasma concentrations and potentiate the risk of overdose and fatal respiratory depression.

MANAGEMENT: Pharmacologic response to the opioid should be monitored more closely whenever a CYP450 3A4 inducer is added to or withdrawn from therapy, and the opioid dosage adjusted as necessary.

References

  1. Holmes VF (1991) "Rifampin-induced methadone withdrawal in AIDS." J Clin Psychopharmacol, 10, p. 443-4
  2. Liu S-J, Wang RI (1984) "Case report of barbiturate-induced enhancement of methadone metabolism and withdrawal syndrome." Am J Psychiatry, 141, p. 1287-8
  3. Bell J, Seres V, Bowron P, Lewis J, Batey R (1988) "The use of serum methadone levels in patients receiving methadone maintenance." Clin Pharmacol Ther, 43, p. 623-9
  4. Finelli PF (1976) "Phenytoin and methadone tolerance." N Engl J Med, 294, p. 227
  5. Tong TG, Pond SM, Kreek MJ, et al. (1981) "Phenytoin-induced methadone withdrawal." Ann Intern Med, 94, p. 349-51
  6. Kreek MJ, Garfield JW, Gutjahr CL, Giusti LM (1976) "Rifampin-induced methadone withdrawal." N Engl J Med, 294, p. 1104-6
  7. Bending MR, Skacel PO (1977) "Rifampicin and methadone withdrawal." Lancet, 1, p. 1211
  8. "Product Information. Duragesic Transdermal System (fentanyl)." Janssen Pharmaceutica, Titusville, NJ.
  9. (2001) "Product Information. OxyContin (oxycodone)." Purdue Frederick Company
  10. Raistrick D, Hay A, Wolff K (1996) "Methadone maintenance and tuberculosis treatment." BMJ, 313, p. 925-6
  11. Altice FL, Friedland GH, Cooney EL (1999) "Nevirapine induced opiate withdrawal among injection drug users with HIV infection receiving methadone." AIDS, 13, p. 957-62
  12. Otero MJ, Fuertes A, Sanchez R, Luna G (1999) "Nevirapine-induced withdrawal symptoms in HIV patients on methadone maintenance programme: an alert." AIDS, 13, p. 1004-5
  13. Pinzani V, Faucherre V, Peyriere H, Blayac JP (2000) "Methadone withdrawal symptoms with nevirapine and efavirenz." Ann Pharmacother, 34, p. 405-7
  14. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  15. (2006) "Product Information. Ionsys (fentanyl)." Ortho McNeil Pharmaceutical
  16. (2007) "Product Information. Diskets (methadone)." Cebert Pharmaceuticals Inc
  17. Cerner Multum, Inc. "Australian Product Information."
  18. (2013) "Product Information. Zohydro ER (hydrocodone)." Zogenix, Inc
  19. (2017) "Product Information. Butorphanol Tartrate (butorphanol)." Apotex Corporation
View all 19 references

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Drug and food interactions

Major

oliceridine food

Applies to: oliceridine

GENERALLY AVOID: Alcohol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics including oliceridine. Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills. In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur.

GENERALLY AVOID: Grapefruit or grapefruit juice may increase the plasma concentrations of oliceridine by inhibiting the CYP450 3A4-mediated metabolism of oliceridine, although the interaction has not been studied. 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: Patients should not consume alcoholic beverages or use drug products that contain alcohol during treatment with oliceridine. Any history of alcohol or illicit drug use should be considered when prescribing oliceridine, and therapy initiated at a lower dosage if necessary. Patients should be closely monitored for signs and symptoms of sedation, respiratory depression, and hypotension. Due to a high degree of interpatient variability with respect to grapefruit juice interactions, patients treated with oliceridine should preferably avoid the consumption of grapefruit and grapefruit juice.

References

  1. (2020) "Product Information. Olinvyk (oliceridine)." Trevena Inc

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Moderate

deferasirox food

Applies to: deferasirox

ADJUST DOSING INTERVAL: According to product labeling, the bioavailability of deferasirox was variably increased when taken with a meal.

MANAGEMENT: To ensure consistent plasma drug levels, deferasirox should be taken on an empty stomach 30 minutes before eating preferably at the same time everyday.

References

  1. (2005) "Product Information. Exjade (deferasirox)." Novartis Pharmaceuticals

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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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