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Drug Interactions between rifapentine and zuranolone

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

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Interactions between your drugs

Major

rifapentine zuranolone

Applies to: rifapentine and zuranolone

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration of zuranolone with CYP450 3A4 inducers may significantly reduce the plasma concentrations and systemic effects of zuranolone. The proposed mechanism is induction of the CYP450 3A4-mediated metabolism of zuranolone, which is primarily metabolized by this isoenzyme. Drug interaction studies have shown that coadministration with the potent CYP450 3A4 inducer rifampin decreased the systemic exposure (AUC) and peak plasma concentration (Cmax) by approximately 80% and 70%, respectively. However, data for less potent CYP450 3A4 inducers are lacking.

MANAGEMENT: Concomitant use of zuranolone with potent CYP450 3A4 inducers should generally be avoided. In addition, until further information is available, concomitant use with moderate CYP450 3A4 inducers should also be avoided.

References

  1. "Product Information. Zurzuvae (zuranolone)." Biogen Inc. (2023):

Drug and food interactions

Moderate

rifapentine food

Applies to: rifapentine

Consumer information for this interaction is not currently available.

ADJUST DOSING INTERVAL: Administration with food may increase the oral bioavailability of rifapentine and reduce the incidence of gastrointestinal adverse events. Administration with a high fat meal typically increases rifapentine's maximum concentration (Cmax) and systemic exposure (AUC) by approximately 40% to 50% over that observed when rifapentine is administered under fasting conditions. Rifapentine is often prescribed in combination with isoniazid. When single doses of rifapentine (900 mg) and isoniazid (900 mg) were administered with a low fat, high carbohydrate breakfast, the Cmax and AUC of rifapentine increased by 47% and 51%, respectively. On the other hand, isoniazid's Cmax and AUC decreased by 46% and 23%, respectively.

MANAGEMENT: Products containing oral rifapentine as the sole ingredient recommend administration with a meal to increase bioavailability and reduce the occurrence of gastrointestinal upset, nausea, and/or vomiting. Consultation of product labeling for combination products and/or relevant guidelines may be helpful if rifapentine is combined with a medication that is typically taken on an empty stomach.

References

  1. "Product Information. Isoniazid/Rifapentine 300 mg/300 mg (Macleods) (isoniazid-rifapentine)." Imported (India) 2 (2021):
  2. "Product Information. Priftin (rifapentine)." sanofi-aventis (2021):
Moderate

zuranolone food

Applies to: zuranolone

Consumer information for this interaction is not currently available.

ADJUST DOSING INTERVAL: Food enhances the oral bioavailability of zuranolone. When administered with a low-fat meal (e.g., 400 to 500 calories, 25% fat), zuranolone peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 3.5- and 1.8-fold, respectively, compared to administration under fasted conditions. Zuranolone was administered with food in the premarketing study population. The efficacy of zuranolone when administered in the fasted state is unknown.

GENERALLY AVOID: Concomitant use of zuranolone with central nervous system (CNS) depressants, including alcohol, may potentiate adverse effects such as somnolence, confusion, dizziness, and gait disturbance.

MANAGEMENT: Zuranolone must be administered with fat-containing food (e.g., 400 to 1,000 calories, 25% to 50% fat) according to the manufacturer. Patients should also be advised to avoid or limit consumption of alcohol and to avoid activities requiring mental alertness such as driving or operating hazardous machinery until at least 12 hours after administration of zuranolone.

References

  1. "Product Information. Zurzuvae (zuranolone)." Biogen Inc. (2023):

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.