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Drug Interaction Report

5 potential interactions and/or warnings found for the following 2 drugs:

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Interactions between your drugs

Moderate

acetaminophen butalbital

Applies to: Esgic-Plus (acetaminophen / butalbital / caffeine), Esgic-Plus (acetaminophen / butalbital / caffeine)

Using acetaminophen together with butalbital may alter the effects of acetaminophen and cause serious side effects that may affect your liver. Call your doctor immediately if you experience a fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash or itching, loss of appetite, nausea, vomiting, or yellowing of the skin or the whites of your eyes. If your doctor does prescribe these medications together, you may need a dose adjustment or special tests to safely take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

butalbital cabazitaxel

Applies to: Esgic-Plus (acetaminophen / butalbital / caffeine), cabazitaxel

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with CYP450 3A4 inducers may decrease the plasma concentration and pharmacologic effects of cabazitaxel, which is primarily metabolized via the isoenzyme. A drug interaction study in patients with advanced cancers (n=21), revealed that repeated administration of rifampin (600 mg once daily), a potent CYP450 3A4 inducer, increased the clearance and decreased the systemic exposure (AUC) of cabazitaxel (15 mg/m2 intravenous) by 21% and 17%, respectively. In another study, adult patients with metastatic castration-resistant prostate cancer (n=14), received cabazitaxel (25 mg/m2 intravenous) at baseline (day 0) and then every 3 weeks for 3 doses. The potent CYP450 3A4 inducer enzalutamide (160 mg oral daily) was started at day 8 (+/- 1) and continued until 1 week after the 3rd dose of cabazitaxel (6 weeks of concurrent treatment). A 22% reduction in the AUC of cabazitaxel was observed when compared to baseline, which investigators noted was potentially clinically relevant, and could result in subtherapeutic concentrations when lower doses of cabazitaxel (e.g., 20 mg/m2) are utilized. Clinical data with less potent CYP450 3A4 inducers are not available.

MANAGEMENT: Concomitant use of cabazitaxel, a narrow therapeutic index drug, with CYP450 3A4 inducers should be done with caution. The possibility of diminished therapeutic effects should be considered, particularly when lower dosing of cabazitaxel is utilized. Alternative agents that do not induce CYP450 3A4 may be required if an interaction is suspected.

Drug and food interactions

Major

acetaminophen food

Applies to: Esgic-Plus (acetaminophen / butalbital / caffeine)

Ask your doctor before using acetaminophen together with ethanol. This can cause serious side effects that affect your liver. Call your doctor immediately if you experience a fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash or itching, loss of appetite, nausea, vomiting, or yellowing of the skin or the whites of your eyes. If your doctor does prescribe these medications together, you may need a dose adjustment or special tests to safely take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Major

butalbital food

Applies to: Esgic-Plus (acetaminophen / butalbital / caffeine)

Ask your doctor before using butalbital together with ethanol, this can add to dizziness, drowsiness and other side effects of butalbital. Be careful if you drive or do activities that require you to be awake and alert. Talk with your doctor before using any medications together, or drinking alcohol with butalbital. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Minor

caffeine food

Applies to: Esgic-Plus (acetaminophen / butalbital / caffeine)

Information for this minor interaction is available on the professional version.

Therapeutic duplication warnings

No duplication 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.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.