Drug Interactions between Advair Diskus and solriamfetol

MONITOR: Additive or synergistic effects on blood pressure and/or heart rate may occur when solriamfetol is combined with other drugs that increase blood pressure and/or heart rate. The use of solriamfetol alone has been associated with dose-dependent increases in blood pressure and heart rate. Combined use of solriamfetol with other drugs that increase blood pressure and/or heart rate has not been studied.

MANAGEMENT: Caution is advised if solriamfetol is used with other drugs that increase blood pressure and/or heart rate. Blood pressure should be monitored prior to initiating solriamfetol therapy and regularly during treatment. In addition, hypertension should be controlled prior to treatment, and any new-onset hypertension or exacerbations of pre-existing hypertension that occur during solriamfetol therapy should be treated. Discontinuation of solriamfetol should be considered in patients who experience an increase in blood pressure or heart rate that cannot be managed with dose reduction of solriamfetol or other appropriate medical intervention.

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Although they are often combined in clinical practice, the concomitant use of beta-2 adrenergic agonists and corticosteroids may result in additive hypokalemic effects. Since beta-2 agonists can sometimes cause QT interval prolongation, the development of hypokalemia may potentiate the risk of ventricular arrhythmias including torsade de pointes. However, clinical data are limited, and the potential significance is unknown. Patients who are receiving systemic or nebulized formulations of beta-2 agonists, high dosages of inhaled beta-2 agonists, or systemic corticosteroid therapy may be at a greater risk of developing hypokalemia.

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