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Drug Interactions between methylnaltrexone and risdiplam

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

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Interactions between your drugs

Moderate

methylnaltrexone risdiplam

Applies to: methylnaltrexone and risdiplam

GENERALLY AVOID: Coadministration with risdiplam may increase the plasma concentrations and risk of adverse effects of drugs that are substrates of multidrug and toxin extrusion 1 and 2K (MATE1 and MATE2K) proteins. Based on in vitro data, risdiplam and its metabolite are MATE1 and MATE2K transport inhibitors. The proposed mechanism is decreased clearance due to risdiplam-mediated inhibition of MATE1 and/or MATE2K.

MANAGEMENT: Coadministration of risdiplam with drugs that are substrates of MATE1 and/or MATE2K should generally be avoided. However, if concomitant use is unavoidable, monitor for drug-related toxicities and consider dosage reduction of the MATE1 or MATE2K substrate (based in the labeling of that drug) as needed.

References

  1. Cerner Multum, Inc. "Australian Product Information."
  2. (2020) "Product Information. Evrysdi (risdiplam)." Genentech
  3. Yonezawa A, Inui K (2011) "Importance of the multidrug and toxin extrusion MATE/SLC47A family to pharmacokinetics, pharmacodynamics/toxicodynamics and pharmacogenomics." Br J Pharmacol, 164, p. 1817-25

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Drug and food interactions

Moderate

methylnaltrexone food

Applies to: methylnaltrexone

ADJUST DOSING INTERVAL: Food may reduce the rate and extent of absorption of methylnaltrexone following oral administration. When a single 450 mg oral dose of methylnaltrexone was administered with a high-fat breakfast (approximately 800 to 1000 calories; 60% from fat, 25% from carbohydrate, and 15% from protein) in healthy study subjects, methylnaltrexone peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 60% and 43%, respectively, while time to reach Cmax delayed by 2 hours.

MANAGEMENT: Oral methylnaltrexone should be taken with water on an empty stomach at least 30 minutes before the first meal of the day.

References

  1. (2008) "Product Information. Relistor (methylnaltrexone)." Wyeth Laboratories

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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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