zafirlukast and Aliskiren Interactions

Interactions between zafirlukast and Aliskiren (aliskiren)

zafirlukast and aliskiren (Moderate Drug-Drug)

MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations and pharmacologic effects of aliskiren, which is primarily metabolized by the isoenzyme. According to the product labeling, plasma levels of aliskiren were increased approximately 80% by the potent CYP450 3A4 inhibitor ketoconazole at a dosage of 200 mg twice daily. A 400 mg once daily dose of ketoconazole was not studied but would be expected to further increase aliskiren blood levels.

MANAGEMENT: Pharmacologic response to aliskiren should be monitored more closely whenever a CYP450 3A4 inhibitor is added to or withdrawn from therapy, and the aliskiren dosage adjusted if necessary. Patients should be advised to notify their physician if they experience excessive adverse effects of aliskiren such as dizziness, lightheadedness, diarrhea, abdominal pain, and gastroesophageal reflux.