zafirlukast and Abilify discmelt Interactions

Interactions between zafirlukast and Abilify discmelt (aripiprazole)

zafirlukast and aripiprazole (Moderate Drug-Drug)

MONITOR: Coadministration with inhibitors of CYP450 2D6 and/or 3A4 may increase the plasma concentrations of aripiprazole, which is metabolized by these isoenzymes. According to the manufacturer, ketoconazole (200 mg/day for 14 days), a potent CYP450 3A4 inhibitor, increased the area under the plasma concentration-time curve (AUC) of aripiprazole (15 mg single dose) and its active metabolite, dehydro-aripiprazole, by 63% and 77%, respectively. Quinidine (166 mg/day for 13 days), a potent CYP450 2D6 inhibitor, increased the AUC of aripiprazole (10 mg single dose) by 112% but decreased the AUC of dehydro-aripiprazole by 35%.

MANAGEMENT: Pharmacologic response to aripiprazole should be monitored more closely whenever a CYP450 2D6 and/or 3A4 inhibitor is added to or withdrawn from therapy, and the aripiprazole dosage adjusted as necessary. The manufacturer recommends that aripiprazole dosage be reduced to one-half the normal dosage during concomitant administration with ketoconazole or quinidine, and additional dosage adjustments be based on clinical evaluation. No dosage recommendations are available for concomitant administration with less potent CYP450 2D6 or 3A4 inhibitors.