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Drug Interactions between PhenazoForte Plus and vortioxetine

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

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Interactions between your drugs

Moderate

butabarbital vortioxetine

Applies to: PhenazoForte Plus (butabarbital / hyoscyamine / phenazopyridine) and vortioxetine

ADJUST DOSE: Coadministration with potent inducers of CYP450 isoenzymes may significantly decrease the plasma concentrations of vortioxetine, which is primarily metabolized by CYP450 2D6. According to the product labeling, administration of vortioxetine with the potent CYP450 inducer rifampin resulted in an approximately 50% decrease in vortioxetine peak plasma concentration (Cmax) and 75% decrease in systemic exposure (AUC) compared to administration of vortioxetine alone.

MANAGEMENT: An increase in the dosage of vortioxetine should be considered when used in combination with potent CYP450 inducers (e.g., carbamazepine, phenobarbital, phenytoin, rifamycins) for greater than 14 days, up to a maximum of three times the original dosage depending on clinical response. Following discontinuation of the potent CYP450 inducer, vortioxetine dosage should be returned to the original level within 14 days. Other known CYP450 inducers include aminoglutethimide, barbiturates, bexarotene, bosentan, enzalutamide, efavirenz, etravirine, nevirapine, somatrem, somatropin, and various other anticonvulsants, although the extent to which they interact with vortioxetine is unknown. If concomitant use is required, close monitoring for signs of reduced therapeutic efficacy is advised, and the vortioxetine dosage adjusted as necessary.

References

  1. (2013) "Product Information. Brintellix (vortioxetine)." Takeda Pharmaceuticals America

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Drug and food interactions

Major

butabarbital food

Applies to: PhenazoForte Plus (butabarbital / hyoscyamine / phenazopyridine)

GENERALLY AVOID: Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.

MANAGEMENT: The combination of ethanol and barbiturates should be avoided.

References

  1. Gupta RC, Kofoed J (1966) "Toxological statistics for barbiturates, other sedatives, and tranquilizers in Ontario: a 10-year survey." Can Med Assoc J, 94, p. 863-5
  2. Misra PS, Lefevre A, Ishii H, Rubin E, Lieber CS (1971) "Increase of ethanol, meprobamate and pentobarbital metabolism after chronic ethanol administration in man and in rats." Am J Med, 51, p. 346-51
  3. Saario I, Linnoila M (1976) "Effect of subacute treatment with hypnotics, alone or in combination with alcohol, on psychomotor skills related to driving." Acta Pharmacol Toxicol (Copenh), 38, p. 382-92
  4. Stead AH, Moffat AC (1983) "Quantification of the interaction between barbiturates and alcohol and interpretation of fatal blood concentrations." Hum Toxicol, 2, p. 5-14
  5. Seixas FA (1979) "Drug/alcohol interactions: avert potential dangers." Geriatrics, 34, p. 89-102
View all 5 references

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Moderate

vortioxetine food

Applies to: vortioxetine

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

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Moderate

hyoscyamine food

Applies to: PhenazoForte Plus (butabarbital / hyoscyamine / phenazopyridine)

GENERALLY AVOID: Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous. In addition, the potential for abuse may be increased with the combination. The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system. No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load. However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.

MANAGEMENT: Alcohol should generally be avoided during therapy with anticholinergic agents. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.

References

  1. Linnoila M (1973) "Drug effects on psychomotor skills related to driving: interaction of atropine, glycopyrrhonium and alcohol." Eur J Clin Pharmacol, 6, p. 107-12

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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

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