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Drug Interactions between Abilify and troglitazone

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

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Interactions between your drugs

Moderate

troglitazone ARIPiprazole

Applies to: troglitazone and Abilify (aripiprazole)

MONITOR: Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of aripiprazole and its active metabolite, dehydro-aripiprazole. Clinical and in vitro data indicate that aripiprazole is extensively metabolized in the liver primarily via three enzymatic pathways (dehydrogenation, hydroxylation, and N-dealkylation) mediated by CYP450 2D6 and 3A4. When aripiprazole 30 mg once daily was coadministered with the potent CYP450 3A4 inducer carbamazepine at 200 mg twice daily in schizophrenic patients, mean aripiprazole peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 68% and 73%, respectively, compared to administration of aripiprazole alone. Likewise, mean Cmax and AUC of dehydro-aripiprazole were decreased by 69% and 71%, respectively, in the presence of carbamazepine. The interaction has not been studied with other, less potent inducers.

MANAGEMENT: Pharmacologic response to aripiprazole should be monitored more closely whenever a CYP450 3A4 inducer is added to or withdrawn from therapy, and the aripiprazole dosage adjusted as necessary. The prescribing information for individual aripiprazole products should be consulted for specific recommendations regarding concomitant use with CYP450 3A4 inducers.

References (10)
  1. (2022) "Product Information. Abilify (ARIPiprazole)." Bristol-Myers Squibb
  2. (2023) "Product Information. Abilify Maintena (ARIPiprazole)." Otsuka American Pharmaceuticals Inc
  3. (2022) "Product Information. Aristada (ARIPiprazole)." Alkermes, Inc
  4. (2022) "Product Information. Aristada Initio (ARIPiprazole)." Alkermes, Inc
  5. (2021) "Product Information. Abilify (aripiprazole)." Otsuka Pharmaceutical Co Ltd
  6. (2021) "Product Information. Abilify Maintena (aripiprazole)." Otsuka Pharmaceutical Co Ltd
  7. (2023) "Product Information. Abilify (aripiprazole)." Otsuka Pharmaceuticals (U.K.) Ltd
  8. (2022) "Product Information. Abilify Maintena (aripiprazole)." Otsuka Pharmaceuticals (U.K.) Ltd
  9. (2022) "Product Information. Abilify (ARIPiprazole)." Otsuka Australia Pharmaceutical Pty Ltd
  10. (2022) "Product Information. Abilify Maintena (ARIPiprazole)." Lundbeck Australia Pty Ltd

Drug and food interactions

Moderate

troglitazone food

Applies to: troglitazone

GENERALLY AVOID: Alcohol may cause hypoglycemia or hyperglycemia in patients with diabetes. Hypoglycemia most frequently occurs during acute consumption of alcohol. Even modest amounts can lower blood sugar significantly, especially when the alcohol is ingested on an empty stomach or following exercise. The mechanism involves inhibition of both gluconeogenesis as well as the counter-regulatory response to hypoglycemia. Episodes of hypoglycemia may last for 8 to 12 hours after ethanol ingestion. By contrast, chronic alcohol abuse can cause impaired glucose tolerance and hyperglycemia. Moderate alcohol consumption generally does not affect blood glucose levels in patients with well controlled diabetes. A disulfiram-like reaction (e.g., flushing, headache, and nausea) to alcohol has been reported frequently with the use of chlorpropamide and very rarely with other sulfonylureas.

MANAGEMENT: Patients with diabetes should avoid consuming alcohol if their blood glucose is not well controlled, or if they have hypertriglyceridemia, neuropathy, or pancreatitis. Patients with well controlled diabetes should limit their alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with their normal meal plan. Alcohol should not be consumed on an empty stomach or following exercise.

References (10)
  1. Jerntorp P, Almer LO (1981) "Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes." Acta Med Scand, 656, p. 33-6
  2. Jerntorp P, Almer LO, Holin H, et al. (1983) "Plasma chlorpropamide: a critical factor in chlorpropamide-alcohol flush." Eur J Clin Pharmacol, 24, p. 237-42
  3. Barnett AH, Spiliopoulos AJ, Pyke DA, et al. (1983) "Metabolic studies in chlorpropamide-alcohol flush positive and negative type 2 (non-insulin dependent) diabetic patients with and without retinopathy." Diabetologia, 24, p. 213-5
  4. Hartling SG, Faber OK, Wegmann ML, Wahlin-Boll E, Melander A (1987) "Interaction of ethanol and glipizide in humans." Diabetes Care, 10, p. 683-6
  5. (2002) "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals
  6. (2002) "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals
  7. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  8. Skillman TG, Feldman JM (1981) "The pharmacology of sulfonylureas." Am J Med, 70, p. 361-72
  9. (2002) "Position Statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes related complications. American Diabetes Association." Diabetes Care, 25(Suppl 1), S50-S60
  10. Cerner Multum, Inc. "UK Summary of Product Characteristics."
Moderate

ARIPiprazole food

Applies to: Abilify (aripiprazole)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete 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.

References (4)
  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc

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.

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