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Drug Interactions between mifepristone and sildenafil

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

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Interactions between your drugs

Major

sildenafil miFEPRIStone

Applies to: sildenafil and mifepristone

Consumer information for this interaction is not currently available.

CONTRAINDICATED: Coadministration with mifepristone may significantly increase the plasma concentrations of drugs that are primarily metabolized by the CYP450 3A4 isoenzyme. The mechanism is decreased clearance due to inhibition of CYP450 3A4 activity by mifepristone. When a single 80 mg dose of simvastatin, a sensitive CYP450 3A4 substrate, was administered following pretreatment with mifepristone 1200 mg once daily for 10 days, simvastatin peak plasma concentration (Cmax) and systemic exposure (AUC) increased by approximately 7- and 10-fold, respectively. Likewise, the Cmax and AUC of simvastatin acid, the pharmacologically active metabolite, increased by approximately 18- and 16-fold, respectively.

MANAGEMENT: When mifepristone is used daily to control hyperglycemia secondary to hypercortisolism in patients with endogenous Cushing's syndrome, concomitant use of CYP450 3A4 substrates with narrow therapeutic ranges and high first-pass effect is considered contraindicated. These drugs include lovastatin, simvastatin, cyclosporine, ergot derivatives, fentanyl, oral midazolam, triazolam, pimozide, quinidine, sildenafil, sirolimus, and tacrolimus. The contraindication does not apply when mifepristone is used on a limited basis to terminate a pregnancy, but caution and close monitoring are advisable. Because mifepristone is eliminated slowly from the body, drug interactions may be observed for a prolonged period following discontinuation (approximately 2 to 3 weeks if mifepristone had been administered chronically to steady state).

Drug and food interactions

Moderate

sildenafil food

Applies to: sildenafil

If you are receiving therapy with sildenafil you should avoid the regular consumption of large amounts of grapefruits and grapefruit juice. Grapefruit can raise the levels of sildenafil in your body and delay the time it takes for the medication to work. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

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Moderate

miFEPRIStone food

Applies to: mifepristone

Food increases the blood levels of this medication. If you are only receiving one or two doses, you may take it without regard to meals. However, if you are receiving the medication for long-term treatment, you should take it with food at the same time everyday to maintain consistent blood levels and effects. Avoid consuming grapefruit or grapefruit juice during treatment, as it may increase blood levels of the medication to undesirable levels and increase the risk of side effects, including headache, dizziness, fatigue, nausea, vomiting, cramping, diarrhea, hypokalemia (low blood potassium), fluid retention, swelling, and high blood pressure. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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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.

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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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