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Drug Interactions between oxcarbazepine and Sirturo

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

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Interactions between your drugs

Moderate

OXcarbazepine bedaquiline

Applies to: oxcarbazepine and Sirturo (bedaquiline)

MONITOR: Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of bedaquiline, which is primarily metabolized by CYP450 3A4 to the major N-monodesmethyl metabolite, M2. Because M2 is 4- to 6-fold less active than the parent drug in terms of antimycobacterial potency, the interaction may diminish the therapeutic effect of bedaquiline. In healthy volunteers, administration of a single 300 mg dose of bedaquiline in combination with the potent CYP450 3A4 inducer rifampin (600 mg once daily for 21 days) reduced bedaquiline systemic exposure (AUC) by 52% compared to administration alone. No data are available for use with other, less potent CYP450 3A4 or P-gp inducers.

MANAGEMENT: Caution is advised when bedaquiline is used in combination with inducers of CYP450 3A4 due to the potential for reduced antimycobacterial effect.

References

  1. "Product Information. Sirturo (bedaquiline)." Janssen Pharmaceuticals (2013):

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Drug and food interactions

Moderate

OXcarbazepine food

Applies to: oxcarbazepine

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
  3. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  4. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
View all 4 references

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Moderate

bedaquiline food

Applies to: Sirturo (bedaquiline)

ADJUST DOSING INTERVAL: Food enhances the oral bioavailability of bedaquiline. When administered with a standard meal containing approximately 22 grams of fat (558 total Kcal), the relative bioavailability of bedaquiline increased by approximately 2-fold compared to administration under fasted conditions.

GENERALLY AVOID: Coadministration with alcohol may increase the risk of hepatotoxicity associated with the use of bedaquiline. In clinical trials, hepatic adverse drug reactions developed in more bedaquiline-treated patients than in those who received other drugs used to treat tuberculosis. In patients receiving bedaquiline or placebo in combination with other drugs used to treat multidrug-resistant tuberculosis, reversible aminotransferase elevations of at least 3 times the upper limit of normal developed more frequently in the bedaquiline treatment group [10.8%] than in the placebo group [5.7%].

MANAGEMENT: To ensure maximal oral absorption, bedaquiline should be taken with food. Patients should avoid alcohol use during treatment.

References

  1. "Product Information. Sirturo (bedaquiline)." Janssen Pharmaceuticals (2013):

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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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