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Can you take Alfenta with Mobocertinib?

1 drug interaction and 36 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

ALfentanil mobocertinib

Applies to: Alfenta (alfentanil) and mobocertinib

Mobocertinib may decrease the blood levels and effects of ALfentanil.

Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Contact your doctor if your condition changes.

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.

Food/lifestyle interactions

Major food/lifestyle interactions

Major:

ALfentanil Food/Lifestyle

Applies to: Alfenta (alfentanil)

Do not use alcohol or medications that contain alcohol while you are receiving treatment with ALfentanil.

This may increase nervous system side effects such as:

  • drowsiness
  • dizziness
  • lightheadedness
  • difficulty concentrating
  • impairment in thinking and judgment

In severe cases, low blood pressure, respiratory distress, fainting, coma, or even death may occur.

You should also avoid consuming grapefruit and grapefruit juice, as this may increase the blood levels and effects of ALfentanil.

If you are taking an extended-release formulation, the pill should be swallowed whole (i.E., do not crush, chew, or divide the pill). Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed.

Do not exceed the dose of ALfentanil prescribed for you or use the medication more frequently or for a longer duration than prescribed by your doctor.

Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.

It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.

Major:

mobocertinib Food/Lifestyle

Applies to: mobocertinib

You should avoid consumption of grapefruit and grapefruit juice during treatment with mobocertinib.

Grapefruit juice can increase the blood levels of mobocertinib. This may increase the risk of side effects such as:

  • diarrhea
  • nausea
  • vomiting
  • rash
  • fatigue
  • musculoskeletal pain
  • mouth sores and inflammation
  • heart failure
  • rare but potentially serious and life-threatening irregular heart rhythm disorders

Talk to your doctor if you have any questions or concerns. 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.

Major:

ALfentanil Alcohol (Ethanol)

Applies to: Alfenta (alfentanil)

Do not use ethanol (alcohol) while you are receiving treatment with ALfentanil.

This may increase nervous system side effects such as:

  • drowsiness
  • dizziness
  • lightheadedness
  • difficulty concentrating
  • impairment in thinking and judgment

In severe cases, low blood pressure, respiratory distress, fainting, coma, or even death may occur.

Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed.

Do not use more than the recommended dose of ALfentanil and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.

It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.

Disease interactions

33 potential interactions Applies to: 27 conditions, including Heart Failure, Seizures, Arrhythmia, Hypokalemia, and Hypotension.

Acute Alcohol Intoxication

Major:

Alfenta

The ALfentanil in Alfenta has a major potential interaction with Acute Alcohol Intoxication.

The use of opiate agonists is contraindicated in patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of opiate agonists may be additive with those of alcohol. Severe respiratory depression and death may occur. Therapy with opiate agonists should be administered cautiously in patients who might be prone to acute alcohol intake.

Adrenal Insufficiency

Moderate:

Alfenta

The ALfentanil in Alfenta has a moderate potential interaction with Adrenal Insufficiency.

Patients with Addison's disease may have increased risk of respiratory depression and prolonged CNS depression associated with the use of narcotic (opioid) analgesic agents. Conversely, these agents may cause or potentiate adrenal insufficiency. Therapy with opioids should be administered cautiously and initiated at reduced dosages in patients with adrenocortical insufficiency. Subsequent doses should be titrated based on individual response rather than a fixed dosing schedule.

Altered Consciousness

Major:

Alfenta

The ALfentanil in Alfenta has a major potential interaction with Altered Consciousness.

Opiate agonists may produce significant central nervous system and respiratory depression of varying duration, particularly when given in high dosages and/or by rapid intravenous administration. Apnea may result from decreased respiratory drive as well as increased airway resistance, and rigidity of respiratory muscles may occur during rapid IV administration or when these agents are used in the induction of anesthesia. At therapeutic analgesic dosages, the respiratory effects are usually not clinically important except in patients with preexisting pulmonary impairment. Therapy with opiate agonists should be avoided or administered with extreme caution and initiated at reduced dosages in patients with severe CNS depression; sleep apnea; hypoxia, anoxia, or hypercapnia; upper airway obstruction; chronic pulmonary insufficiency; a limited ventilatory reserve; or other respiratory disorders. In the presence of excessive respiratory secretions, the use of opiate agonists may also be problematic because they decrease ciliary activity and reduce the cough reflex. Caution is also advised in patients who may be at increased risk for respiratory depression, such as comatose patients or those with head injury, intracranial lesions, or intracranial hypertension. Clinical monitoring of pulmonary function is recommended, and equipment for resuscitation should be immediately available if parenteral or neuraxial routes are used. Naloxone may be administered to reverse clinically significant respiratory depression, which may be prolonged depending on the opioid agent, cumulative dose, and route of administration.

Arrhythmia

Moderate:

Alfenta

The ALfentanil in Alfenta has a moderate potential interaction with Arrhythmia.

Opiate agonists have cholinergic activity. Large doses and/or rapid intravenous administration may produce bradycardia and arrhythmias via stimulation of medullary vagal nuclei. Therapy with opiate agonists should be administered cautiously in patients with a history of arrhythmias. Clinical monitoring of cardiovascular status is recommended during therapy.

Asphyxia

Major:

Alfenta

The ALfentanil in Alfenta has a major potential interaction with Asphyxia.

Opiate agonists may produce significant central nervous system and respiratory depression of varying duration, particularly when given in high dosages and/or by rapid intravenous administration. Apnea may result from decreased respiratory drive as well as increased airway resistance, and rigidity of respiratory muscles may occur during rapid IV administration or when these agents are used in the induction of anesthesia. At therapeutic analgesic dosages, the respiratory effects are usually not clinically important except in patients with preexisting pulmonary impairment. Therapy with opiate agonists should be avoided or administered with extreme caution and initiated at reduced dosages in patients with severe CNS depression; sleep apnea; hypoxia, anoxia, or hypercapnia; upper airway obstruction; chronic pulmonary insufficiency; a limited ventilatory reserve; or other respiratory disorders. In the presence of excessive respiratory secretions, the use of opiate agonists may also be problematic because they decrease ciliary activity and reduce the cough reflex. Caution is also advised in patients who may be at increased risk for respiratory depression, such as comatose patients or those with head injury, intracranial lesions, or intracranial hypertension. Clinical monitoring of pulmonary function is recommended, and equipment for resuscitation should be immediately available if parenteral or neuraxial routes are used. Naloxone may be administered to reverse clinically significant respiratory depression, which may be prolonged depending on the opioid agent, cumulative dose, and route of administration.

Brain Tumor

Major:

Alfenta

The ALfentanil in Alfenta has a major potential interaction with Brain Tumor.

Opiate agonists may produce significant central nervous system and respiratory depression of varying duration, particularly when given in high dosages and/or by rapid intravenous administration. Apnea may result from decreased respiratory drive as well as increased airway resistance, and rigidity of respiratory muscles may occur during rapid IV administration or when these agents are used in the induction of anesthesia. At therapeutic analgesic dosages, the respiratory effects are usually not clinically important except in patients with preexisting pulmonary impairment. Therapy with opiate agonists should be avoided or administered with extreme caution and initiated at reduced dosages in patients with severe CNS depression; sleep apnea; hypoxia, anoxia, or hypercapnia; upper airway obstruction; chronic pulmonary insufficiency; a limited ventilatory reserve; or other respiratory disorders. In the presence of excessive respiratory secretions, the use of opiate agonists may also be problematic because they decrease ciliary activity and reduce the cough reflex. Caution is also advised in patients who may be at increased risk for respiratory depression, such as comatose patients or those with head injury, intracranial lesions, or intracranial hypertension. Clinical monitoring of pulmonary function is recommended, and equipment for resuscitation should be immediately available if parenteral or neuraxial routes are used. Naloxone may be administered to reverse clinically significant respiratory depression, which may be prolonged depending on the opioid agent, cumulative dose, and route of administration.

Major:

Alfenta

The ALfentanil in Alfenta has a major potential interaction with Brain Tumor.

The hypoventilation associated with administration of opiate agonists, particularly by the intravenous route, can induce cerebral hypoxia and vasodilatation with resultant increase in intracranial pressure. Opiate agonists should not be used in patients with suspected or known head injury or increased intracranial pressure. Also, clinicians treating such patients should be aware that opiate agonists may interfere with the evaluation of CNS function, especially with respect to consciousness levels, respiratory status, and pupillary changes.

Cardiomyopathy

Moderate:

mobocertinib

Mobocertinib has a moderate potential interaction with Cardiomyopathy.

Mobocertinib can cause cardiac toxicity (including decreased ejection fraction, cardiomyopathy, and congestive heart failure) resulting in heart failure which can be fatal. Cardiac function (including assessment of left ventricular ejection fraction) should be monitored at baseline and during therapy. Therapy should be withheld, the dose should be reduced, or mobocertinib should be discontinued based on the severity of decreased ejection fraction or heart failure.

Cerebral Vascular Disorder

Major:

Alfenta

The ALfentanil in Alfenta has a major potential interaction with Cerebral Vascular Disorder.

The hypoventilation associated with administration of opiate agonists, particularly by the intravenous route, can induce cerebral hypoxia and vasodilatation with resultant increase in intracranial pressure. Opiate agonists should not be used in patients with suspected or known head injury or increased intracranial pressure. Also, clinicians treating such patients should be aware that opiate agonists may interfere with the evaluation of CNS function, especially with respect to consciousness levels, respiratory status, and pupillary changes.

Major:

Alfenta

The ALfentanil in Alfenta has a major potential interaction with Cerebral Vascular Disorder.

Opiate agonists may produce significant central nervous system and respiratory depression of varying duration, particularly when given in high dosages and/or by rapid intravenous administration. Apnea may result from decreased respiratory drive as well as increased airway resistance, and rigidity of respiratory muscles may occur during rapid IV administration or when these agents are used in the induction of anesthesia. At therapeutic analgesic dosages, the respiratory effects are usually not clinically important except in patients with preexisting pulmonary impairment. Therapy with opiate agonists should be avoided or administered with extreme caution and initiated at reduced dosages in patients with severe CNS depression; sleep apnea; hypoxia, anoxia, or hypercapnia; upper airway obstruction; chronic pulmonary insufficiency; a limited ventilatory reserve; or other respiratory disorders. In the presence of excessive respiratory secretions, the use of opiate agonists may also be problematic because they decrease ciliary activity and reduce the cough reflex. Caution is also advised in patients who may be at increased risk for respiratory depression, such as comatose patients or those with head injury, intracranial lesions, or intracranial hypertension. Clinical monitoring of pulmonary function is recommended, and equipment for resuscitation should be immediately available if parenteral or neuraxial routes are used. Naloxone may be administered to reverse clinically significant respiratory depression, which may be prolonged depending on the opioid agent, cumulative dose, and route of administration.

Dehydration

Major:

Alfenta

The ALfentanil in Alfenta has a major potential interaction with Dehydration.

Opiate agonists can induce vasodilation and significant hypotension, particularly when given in high dosages and/or by rapid intravenous administration. Opiate analgesics cause vasodilatation that may exacerbate hypotension and hypoperfusion and, therefore, are contraindicated in circulatory shock. At therapeutic analgesic dosages, ambulatory patients are more likely to experience dizziness and hypotension than patients who are confined to bed. However, orthostatic hypotension may occur in supine patients upon rising. Therapy with opiate agonists should be administered cautiously and initiated at reduced dosages in patients with hypovolemia, or a predisposition to hypotension. When given by intramuscular or subcutaneous administration, clinicians should also be aware that impaired perfusion in these patients may prevent complete absorption of the drug. With repeated injections, an excessive amount may be absorbed suddenly if normal circulation is reestablished.

Electrolyte Abnormalities

Major:

mobocertinib

Mobocertinib has a major potential interaction with Electrolyte Abnormalities.

Mobocertinib can cause life-threatening QTc prolongation, including torsades de pointes, which can be fatal, and requires monitoring of QTc and electrolytes. QTc and electrolytes should be assessed at baseline and abnormalities in sodium, potassium, calcium, and magnesium should be corrected before starting mobocertinib. QTc and electrolytes should be monitored periodically during therapy. Monitoring frequency should be increased in patients with risk factors for QTc prolongation (such as patients with congenital long QT syndrome, heart disease, or electrolyte abnormalities); caution is recommended in these patients. Therapy should be withheld, the dose should be reduced, or mobocertinib should be discontinued based on the severity of QTc prolongation.

Gastrointestinal Obstruction

Major:

Alfenta

The ALfentanil in Alfenta has a major potential interaction with Gastrointestinal Obstruction.

Opioid analgesics are contraindicated in patients with known or suspected gastrointestinal obstruction, including paralytic ileus.

Head Injury

Major:

Alfenta

The ALfentanil in Alfenta has a major potential interaction with Head Injury.

Opiate agonists may produce significant central nervous system and respiratory depression of varying duration, particularly when given in high dosages and/or by rapid intravenous administration. Apnea may result from decreased respiratory drive as well as increased airway resistance, and rigidity of respiratory muscles may occur during rapid IV administration or when these agents are used in the induction of anesthesia. At therapeutic analgesic dosages, the respiratory effects are usually not clinically important except in patients with preexisting pulmonary impairment. Therapy with opiate agonists should be avoided or administered with extreme caution and initiated at reduced dosages in patients with severe CNS depression; sleep apnea; hypoxia, anoxia, or hypercapnia; upper airway obstruction; chronic pulmonary insufficiency; a limited ventilatory reserve; or other respiratory disorders. In the presence of excessive respiratory secretions, the use of opiate agonists may also be problematic because they decrease ciliary activity and reduce the cough reflex. Caution is also advised in patients who may be at increased risk for respiratory depression, such as comatose patients or those with head injury, intracranial lesions, or intracranial hypertension. Clinical monitoring of pulmonary function is recommended, and equipment for resuscitation should be immediately available if parenteral or neuraxial routes are used. Naloxone may be administered to reverse clinically significant respiratory depression, which may be prolonged depending on the opioid agent, cumulative dose, and route of administration.

Major:

Alfenta

The ALfentanil in Alfenta has a major potential interaction with Head Injury.

The hypoventilation associated with administration of opiate agonists, particularly by the intravenous route, can induce cerebral hypoxia and vasodilatation with resultant increase in intracranial pressure. Opiate agonists should not be used in patients with suspected or known head injury or increased intracranial pressure. Also, clinicians treating such patients should be aware that opiate agonists may interfere with the evaluation of CNS function, especially with respect to consciousness levels, respiratory status, and pupillary changes.

Heart Disease

Major:

mobocertinib

Mobocertinib has a major potential interaction with Heart Disease.

Mobocertinib can cause life-threatening QTc prolongation, including torsades de pointes, which can be fatal, and requires monitoring of QTc and electrolytes. QTc and electrolytes should be assessed at baseline and abnormalities in sodium, potassium, calcium, and magnesium should be corrected before starting mobocertinib. QTc and electrolytes should be monitored periodically during therapy. Monitoring frequency should be increased in patients with risk factors for QTc prolongation (such as patients with congenital long QT syndrome, heart disease, or electrolyte abnormalities); caution is recommended in these patients. Therapy should be withheld, the dose should be reduced, or mobocertinib should be discontinued based on the severity of QTc prolongation.

Heart Failure

Moderate:

mobocertinib

Mobocertinib has a moderate potential interaction with Heart Failure.

Mobocertinib can cause cardiac toxicity (including decreased ejection fraction, cardiomyopathy, and congestive heart failure) resulting in heart failure which can be fatal. Cardiac function (including assessment of left ventricular ejection fraction) should be monitored at baseline and during therapy. Therapy should be withheld, the dose should be reduced, or mobocertinib should be discontinued based on the severity of decreased ejection fraction or heart failure.

Hypocalcemia

Major:

mobocertinib

Mobocertinib has a major potential interaction with Hypocalcemia.

Mobocertinib can cause life-threatening QTc prolongation, including torsades de pointes, which can be fatal, and requires monitoring of QTc and electrolytes. QTc and electrolytes should be assessed at baseline and abnormalities in sodium, potassium, calcium, and magnesium should be corrected before starting mobocertinib. QTc and electrolytes should be monitored periodically during therapy. Monitoring frequency should be increased in patients with risk factors for QTc prolongation (such as patients with congenital long QT syndrome, heart disease, or electrolyte abnormalities); caution is recommended in these patients. Therapy should be withheld, the dose should be reduced, or mobocertinib should be discontinued based on the severity of QTc prolongation.

Hypokalemia

Major:

mobocertinib

Mobocertinib has a major potential interaction with Hypokalemia.

Mobocertinib can cause life-threatening QTc prolongation, including torsades de pointes, which can be fatal, and requires monitoring of QTc and electrolytes. QTc and electrolytes should be assessed at baseline and abnormalities in sodium, potassium, calcium, and magnesium should be corrected before starting mobocertinib. QTc and electrolytes should be monitored periodically during therapy. Monitoring frequency should be increased in patients with risk factors for QTc prolongation (such as patients with congenital long QT syndrome, heart disease, or electrolyte abnormalities); caution is recommended in these patients. Therapy should be withheld, the dose should be reduced, or mobocertinib should be discontinued based on the severity of QTc prolongation.

Hyponatremia

Major:

mobocertinib

Mobocertinib has a major potential interaction with Hyponatremia.

Mobocertinib can cause life-threatening QTc prolongation, including torsades de pointes, which can be fatal, and requires monitoring of QTc and electrolytes. QTc and electrolytes should be assessed at baseline and abnormalities in sodium, potassium, calcium, and magnesium should be corrected before starting mobocertinib. QTc and electrolytes should be monitored periodically during therapy. Monitoring frequency should be increased in patients with risk factors for QTc prolongation (such as patients with congenital long QT syndrome, heart disease, or electrolyte abnormalities); caution is recommended in these patients. Therapy should be withheld, the dose should be reduced, or mobocertinib should be discontinued based on the severity of QTc prolongation.

Hypotension

Major:

Alfenta

The ALfentanil in Alfenta has a major potential interaction with Hypotension.

Opiate agonists can induce vasodilation and significant hypotension, particularly when given in high dosages and/or by rapid intravenous administration. Opiate analgesics cause vasodilatation that may exacerbate hypotension and hypoperfusion and, therefore, are contraindicated in circulatory shock. At therapeutic analgesic dosages, ambulatory patients are more likely to experience dizziness and hypotension than patients who are confined to bed. However, orthostatic hypotension may occur in supine patients upon rising. Therapy with opiate agonists should be administered cautiously and initiated at reduced dosages in patients with hypovolemia, or a predisposition to hypotension. When given by intramuscular or subcutaneous administration, clinicians should also be aware that impaired perfusion in these patients may prevent complete absorption of the drug. With repeated injections, an excessive amount may be absorbed suddenly if normal circulation is reestablished.

Liver Disease

Moderate:

Alfenta

The ALfentanil in Alfenta has a moderate potential interaction with Liver Disease.

Narcotic (opioid) analgesic agents are extensively metabolized by the liver, and several of them (e.g., codeine, hydrocodone, meperidine, methadone, morphine, propoxyphene) have active metabolites that are further converted to inactive substances. The serum concentrations of these agents and their metabolites may be increased and the half-lives prolonged in patients with impaired hepatic function. Therapy with opioids should be administered cautiously and initiated at reduced dosages in patients with liver disease. Subsequent doses should be titrated based on individual response rather than a fixed dosing schedule.

Moderate:

mobocertinib

Mobocertinib has a moderate potential interaction with Liver Disease.

No dosage adjustment of mobocertinib is recommended for patients with mild (total bilirubin up to the upper limit of normal [ULN] and AST greater than ULN or total bilirubin greater than 1 to 1.5 times ULN [1 to 1.5 x ULN] and any AST) or moderate (total bilirubin 1.5 to 3 x ULN and any AST) liver dysfunction. The recommended dosage of mobocertinib has not been established for patients with severe liver dysfunction (total bilirubin greater than 3 times ULN and any AST); caution is recommended in these patients.

Magnesium Imbalance

Major:

mobocertinib

Mobocertinib has a major potential interaction with Magnesium Imbalance.

Mobocertinib can cause life-threatening QTc prolongation, including torsades de pointes, which can be fatal, and requires monitoring of QTc and electrolytes. QTc and electrolytes should be assessed at baseline and abnormalities in sodium, potassium, calcium, and magnesium should be corrected before starting mobocertinib. QTc and electrolytes should be monitored periodically during therapy. Monitoring frequency should be increased in patients with risk factors for QTc prolongation (such as patients with congenital long QT syndrome, heart disease, or electrolyte abnormalities); caution is recommended in these patients. Therapy should be withheld, the dose should be reduced, or mobocertinib should be discontinued based on the severity of QTc prolongation.

Prematurity/Underweight in Infancy

Major:

Alfenta

The ALfentanil in Alfenta has a major potential interaction with Prematurity/Underweight in Infancy.

The use of narcotic (opioid) analgesic agents is contraindicated in premature infants. These agents may cross the immature blood-brain barrier to a greater extent than in adults, resulting in disproportionate respiratory depression.

Pulmonary Impairment

Major:

Alfenta

The ALfentanil in Alfenta has a major potential interaction with Pulmonary Impairment.

Opiate agonists may produce significant central nervous system and respiratory depression of varying duration, particularly when given in high dosages and/or by rapid intravenous administration. Apnea may result from decreased respiratory drive as well as increased airway resistance, and rigidity of respiratory muscles may occur during rapid IV administration or when these agents are used in the induction of anesthesia. At therapeutic analgesic dosages, the respiratory effects are usually not clinically important except in patients with preexisting pulmonary impairment. Therapy with opiate agonists should be avoided or administered with extreme caution and initiated at reduced dosages in patients with severe CNS depression; sleep apnea; hypoxia, anoxia, or hypercapnia; upper airway obstruction; chronic pulmonary insufficiency; a limited ventilatory reserve; or other respiratory disorders. In the presence of excessive respiratory secretions, the use of opiate agonists may also be problematic because they decrease ciliary activity and reduce the cough reflex. Caution is also advised in patients who may be at increased risk for respiratory depression, such as comatose patients or those with head injury, intracranial lesions, or intracranial hypertension. Clinical monitoring of pulmonary function is recommended, and equipment for resuscitation should be immediately available if parenteral or neuraxial routes are used. Naloxone may be administered to reverse clinically significant respiratory depression, which may be prolonged depending on the opioid agent, cumulative dose, and route of administration.

Moderate:

mobocertinib

Mobocertinib has a moderate potential interaction with Pulmonary Impairment.

Mobocertinib can cause interstitial lung disease (ILD)/pneumonitis, which can be fatal. Care should be exercised when using this drug in patients with preexisting pulmonary impairment. Mobocertinib should be immediately withheld in patients with suspected ILD/pneumonitis and permanently discontinued if ILD/pneumonitis is confirmed. Patients should be monitored for new/worsening pulmonary symptoms indicative of ILD/pneumonitis.

Renal Dysfunction

Moderate:

Alfenta

The ALfentanil in Alfenta has a moderate potential interaction with Renal Dysfunction.

Although narcotic (opioid) analgesic agents are generally metabolized by the liver, renal impairment can alter the elimination of these agents and their metabolites (some of which are pharmacologically active), resulting in drug accumulation and increased risk of toxicity. Therapy with opioids should be administered cautiously and initiated at reduced dosages in patients with significantly impaired renal function. Subsequent doses should be titrated based on individual response rather than a fixed dosing schedule.

Moderate:

mobocertinib

Mobocertinib has a moderate potential interaction with Renal Dysfunction.

No dosage adjustment of mobocertinib is recommended for patients with mild to moderate renal dysfunction (estimated glomerular filtration rate [eGFR] 30 to 89 mL/min/1.73 m2 by Modification of Diet in Renal Disease equation). The recommended dosage of mobocertinib has not been established for patients with severe renal dysfunction (eGFR less than 30 mL/min/1.73 m2); caution is recommended in these patients.

Respiratory Arrest

Major:

Alfenta

The ALfentanil in Alfenta has a major potential interaction with Respiratory Arrest.

Opiate agonists may produce significant central nervous system and respiratory depression of varying duration, particularly when given in high dosages and/or by rapid intravenous administration. Apnea may result from decreased respiratory drive as well as increased airway resistance, and rigidity of respiratory muscles may occur during rapid IV administration or when these agents are used in the induction of anesthesia. At therapeutic analgesic dosages, the respiratory effects are usually not clinically important except in patients with preexisting pulmonary impairment. Therapy with opiate agonists should be avoided or administered with extreme caution and initiated at reduced dosages in patients with severe CNS depression; sleep apnea; hypoxia, anoxia, or hypercapnia; upper airway obstruction; chronic pulmonary insufficiency; a limited ventilatory reserve; or other respiratory disorders. In the presence of excessive respiratory secretions, the use of opiate agonists may also be problematic because they decrease ciliary activity and reduce the cough reflex. Caution is also advised in patients who may be at increased risk for respiratory depression, such as comatose patients or those with head injury, intracranial lesions, or intracranial hypertension. Clinical monitoring of pulmonary function is recommended, and equipment for resuscitation should be immediately available if parenteral or neuraxial routes are used. Naloxone may be administered to reverse clinically significant respiratory depression, which may be prolonged depending on the opioid agent, cumulative dose, and route of administration.

Seizures

Moderate:

Alfenta

The ALfentanil in Alfenta has a moderate potential interaction with Seizures.

Narcotic (opioid) analgesic agents may increase the frequency of seizures in patients with seizure disorders, may increase the risk of seizures occurring in other clinical settings associated with seizures, and, at higher dosages, have been reported to induce seizures in patients without history of seizures. Patients with history of seizure disorders should be regularly evaluated for worsened seizure control during therapy. Prolonged meperidine use may increase the risk of toxicity (e.g., seizures) from the accumulation of the active metabolite (normeperidine).

Shock

Major:

Alfenta

The ALfentanil in Alfenta has a major potential interaction with Shock.

Opiate agonists can induce vasodilation and significant hypotension, particularly when given in high dosages and/or by rapid intravenous administration. Opiate analgesics cause vasodilatation that may exacerbate hypotension and hypoperfusion and, therefore, are contraindicated in circulatory shock. At therapeutic analgesic dosages, ambulatory patients are more likely to experience dizziness and hypotension than patients who are confined to bed. However, orthostatic hypotension may occur in supine patients upon rising. Therapy with opiate agonists should be administered cautiously and initiated at reduced dosages in patients with hypovolemia, or a predisposition to hypotension. When given by intramuscular or subcutaneous administration, clinicians should also be aware that impaired perfusion in these patients may prevent complete absorption of the drug. With repeated injections, an excessive amount may be absorbed suddenly if normal circulation is reestablished.

Urinary Retention

Moderate:

Alfenta

The ALfentanil in Alfenta has a moderate potential interaction with Urinary Retention.

Narcotic (opioid) analgesic agents may inhibit the urinary voiding reflex and increase the tone of the vesical sphincter in the bladder. Acute urinary retention requiring catheterization may occur, particularly in patients with prostatic hypertrophy or urethral stricture and in older adult patients. These agents may also decrease urine production via direct effects on the kidney and central stimulation of the release of vasopressin. Therapy with opioids should be administered cautiously in patients with or predisposed to urinary retention and/or oliguria. The effects on smooth muscle tone appear to be the most pronounced with morphine.

More resources

Alfenta

A total of 667 drugs are known to interact with Alfenta.

mobocertinib

A total of 582 drugs are known to interact with mobocertinib.

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.