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Drug Interactions between afatinib and Mysoline

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

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Interactions between your drugs

Moderate

primidone afatinib

Applies to: Mysoline (primidone) and afatinib

ADJUST DOSE: Coadministration with inducers of P-glycoprotein (P-gp) may decrease the plasma concentrations of afatinib, which is a substrate of the efflux transporter. In study subjects, administration of afatinib in combination with the P-gp inducer rifampin (600 mg once daily for 7 days) resulted in a 34% decrease in afatinib systemic exposure.

MANAGEMENT: For patients who require chronic therapy with a P-gp inducer, it may be necessary to increase the daily dose of afatinib by 10 mg as tolerated. The previous dose may be resumed 2 to 3 days after discontinuation of the P-gp inducer.

References (1)
  1. (2013) "Product Information. Gilotrif (afatinib)." Boehringer Ingelheim

Drug and food interactions

Major

primidone food

Applies to: Mysoline (primidone)

GENERALLY AVOID: Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.

MANAGEMENT: The combination of ethanol and barbiturates should be avoided.

References (5)
  1. Gupta RC, Kofoed J (1966) "Toxological statistics for barbiturates, other sedatives, and tranquilizers in Ontario: a 10-year survey." Can Med Assoc J, 94, p. 863-5
  2. Misra PS, Lefevre A, Ishii H, Rubin E, Lieber CS (1971) "Increase of ethanol, meprobamate and pentobarbital metabolism after chronic ethanol administration in man and in rats." Am J Med, 51, p. 346-51
  3. Saario I, Linnoila M (1976) "Effect of subacute treatment with hypnotics, alone or in combination with alcohol, on psychomotor skills related to driving." Acta Pharmacol Toxicol (Copenh), 38, p. 382-92
  4. Stead AH, Moffat AC (1983) "Quantification of the interaction between barbiturates and alcohol and interpretation of fatal blood concentrations." Hum Toxicol, 2, p. 5-14
  5. Seixas FA (1979) "Drug/alcohol interactions: avert potential dangers." Geriatrics, 34, p. 89-102
Moderate

afatinib food

Applies to: afatinib

ADJUST DOSING INTERVAL: Food may reduce the oral bioavailability of afatinib. According to the product labeling, administration of afatinib with a high-fat meal decreased peak plasma concentration (Cmax) by 50% and systemic exposure (AUC) by 39% compared to administration in the fasted state.

MANAGEMENT: Afatinib should be taken at least 1 hour before or 2 hours after a meal.

References (1)
  1. (2013) "Product Information. Gilotrif (afatinib)." Boehringer Ingelheim

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.

See also

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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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