Drug Interactions between DurAct and house dust mite allergen extract
This report displays the potential drug interactions for the following 2 drugs:
- DurAct (bromfenac)
- house dust mite allergen extract
Interactions between your drugs
bromfenac house dust mite allergen extract
Applies to: DurAct (bromfenac) and house dust mite allergen extract
MONITOR: Coadministration of allergenic extracts for allergy immunotherapy with NSAIDS may potentiate the risk of allergic reactions, including anaphylaxis. According to some studies, NSAID use is an augmenting factor influencing immunological mechanisms that can induce more severe allergic reactions and is involved in up to 22% of cases of anaphylactic reactions. The precise mechanism by which NSAIDs can induce anaphylaxis has not been established but may involve enhanced allergen absorption due to increased gastrointestinal permeability related to inhibition of prostaglandin synthesis by NSAIDs. Another proposed mechanism involves a direct impact on the IgE activation of mast cells and basophils, resulting in enhanced degranulation and release of chemical mediators such as histamine, prostaglandins, leukotrienes, and thromboxane. A causal relationship with all allergenic extracts has not been established.
MANAGEMENT: The manufacturer for peanut allergen extract recommends considering using alternatives to NSAIDs or temporarily withholding immunotherapy with allergenic extracts. Individual prescribing information should be consulted for further guidance and clinical monitoring may be considered.
References
- (2023) "Product Information. Palforzia (peanut allergen extract)." Aimmune Therapeutics
- (2022) "Product Information. Palforzia Level 1 (peanut allergen extract)." Aimmune Therapeutics UK Ltd
- Munoz-Cano R, Pascal M, Araujo G, et al. (2023) Mechanisms, Cofactors, and Augmenting Factors Involved in Anaphylaxis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623009/pdf/fimmu-08-01193.pdf
Drug and food interactions
bromfenac food
Applies to: DurAct (bromfenac)
ADJUST DOSE: In-vivo studies have demonstrated that the absorption of bromfenac is greatly reduced if the drug is taken within three and one-half hours following a high fat meal. The concomitant administration of a high fat meal has led to a 75% reduction in peak plasma concentrations and a 60% reduction in total area under the curve. The mechanism has not been described.
MANAGEMENT: An increased dosage of bromfenac (from 25 to 50 mg) may be needed if a high fat meal is consumed. The clinician may want to warn the patient about subtherapeutic analgesic effects if high fat meals are regularly consumed.
References
- "Product Information. DurAct (bromfenac)." Wyeth-Ayerst Laboratories
house dust mite allergen extract food
Applies to: house dust mite allergen extract
ADJUST DOSING INTERVAL: Since sublingual preparations of allergenic extracts are meant to be absorbed directly from tissues under the tongue into the blood stream, consuming food or beverage during or immediately after administration may reduce the systemic bioavailability of the medication.
MONITOR: Coadministration of allergenic extracts for allergy immunotherapy with alcohol may potentiate the risk of allergic reactions, including anaphylaxis. According to some studies, alcohol is an augmenting factor influencing immunological mechanisms that can induce more severe allergic reactions and is involved in up to 15% of cases of anaphylactic reactions. Proposed mechanisms include an increase in allergen absorption from altered permeability of the intestinal epithelial barrier, enhancing mast cell and basophil activation, and an increase in serum IgE concentrations. A causal relationship with all allergenic extracts has not been established.
MANAGEMENT: Food or beverage should not be taken with, or for at least 5 minutes after, the administration of sublingual allergenic extracts. Patients should also avoid swallowing for about 1 minute following placement of the allergen extract under the tongue. Caution is advised if allergenic extracts for immunotherapy are used concomitantly with alcohol. Some manufacturers of peanut allergen extract recommend alcohol not be consumed for 2 hours before, or 2 hours after taking peanut allergen extract and if alcohol use cannot be avoided, that withholding or decreasing peanut allergen dosage should be considered. Individual prescribing information should be consulted for further guidance and clinical monitoring may be considered.
References
- (2014) "Product Information. Grastek (timothy grass pollen allergen extract)." Merck & Co., Inc
- (2014) "Product Information. Ragwitek (ragweed pollen allergen extract)." Merck & Co., Inc
- (2014) "Product Information. Oralair (mixed grass pollens allergen extract)." Greer Laboratories Inc
- Cerner Multum, Inc. (2015) "Canadian Product Information."
- (2023) "Product Information. Palforzia (peanut allergen extract)." Aimmune Therapeutics
- (2022) "Product Information. Palforzia Level 1 (peanut allergen extract)." Aimmune Therapeutics UK Ltd
- Munoz-Cano R, Pascal M, Araujo G, et al. (2023) Mechanisms, Cofactors, and Augmenting Factors Involved in Anaphylaxis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623009/pdf/fimmu-08-01193.pdf
- (2023) "Product Information. Odactra (house dust mite allergen extract)." ALK-Abello 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
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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