Drug Interactions between Pro-Clear AC and tirzepatide

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients. Sedation and impairment of attention, judgment, thinking, and psychomotor skills may increase.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Cautious dosage titration may be required, particularly at treatment initiation. Ambulatory patients should be counseled to avoid hazardous activities requiring 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.

Switch to consumer interaction data

MONITOR: Tirzepatide can delay gastric emptying, which may impact the absorption of concomitantly administered oral medications and cause a decrease in the peak plasma concentration (Cmax) and a delay in the time to reach peak plasma concentration (Tmax). The impact of tirzepatide on gastric emptying has been reported to be dose- and time-dependent, with the greatest effect observed after a single 5 mg dose but diminished after subsequent doses. When acetaminophen was administered following a single 5 mg dose of tirzepatide, acetaminophen Cmax was decreased by 50% and its median Tmax delayed by 1 hour. However, no significant impact on acetaminophen Cmax and Tmax was observed after 4 consecutive weekly doses of tirzepatide (5 mg/5 mg/8 mg/10 mg), and the overall exposure (AUC) of acetaminophen was unaffected. Tirzepatide at lower doses of 0.5 mg and 1.5 mg also had minimal effects on acetaminophen exposure.

MANAGEMENT: Although no specific dosage adjustment of concomitant medications is generally recommended based on available data, potential clinical impact on some oral medications cannot be ruled out, particularly those with a narrow therapeutic index or low bioavailability, those that depend on threshold concentrations for efficacy (e.g., antibiotics), and those that require rapid gastrointestinal absorption (e.g., hypnotics, analgesics). Oral medications with a narrow therapeutic index may require additional monitoring when used in combination with tirzepatide, especially at initiation of tirzepatide and following any dose adjustments. The risk of delayed effects due to delayed gastric emptying should also be considered for any oral medications that require a rapid onset of action.

Switch to consumer interaction data

MONITOR: Additive increases in heart rate may occur when tirzepatide is coadministered with other drugs that can also increase heart rate. The mechanism by which tirzepatide may affect heart rate is unknown. In placebo-controlled trials, treatment with tirzepatide resulted in an average increase in heart rate of 2 to 4 beats per minute (bpm) compared to an average increase of 1 bpm in patients receiving placebo. The incidence of patients who had a change in heart rate of greater than 20 bpm from baseline for 2 or more consecutive visits was 2.1%, 3.8% and 2.9% for tirzepatide 5 mg, 10 mg and 15 mg, respectively, compared with 2.1% for placebo. Episodes of sinus tachycardia, associated with a concomitant increase in heart rate of greater than or equal to 15 bpm from baseline, were reported in 4.3%, 4.6%, 5.9% and 10% of subjects treated with placebo or tirzepatide 5 mg, 10 mg and 15 mg, respectively. For patients enrolled in Japan, the reported frequencies of these episodes were 7% (3/43), 7.1% (3/42), 9.3% (4/43) and 23% (10/43), respectively.

MANAGEMENT: Although the clinical relevance of the effects on heart rate is not currently known, some authorities suggest observing caution when tirzepatide is coadministered with other drugs that can increase heart rate such as those with sympathomimetic or anticholinergic activity. Advise patients of the potential risk of tachycardia and to contact their healthcare provider if it occurs in the absence of a known cause (i.e., at rest).

Switch to consumer interaction data