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Drug Interactions between Allegra-D 24 Hour Allergy & Congestion and maralixibat

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

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Interactions between your drugs

Moderate

fexofenadine maralixibat

Applies to: Allegra-D 24 Hour Allergy & Congestion (fexofenadine / pseudoephedrine) and maralixibat

MONITOR: Coadministration with maralixibat may decrease the plasma concentrations of drugs that are substrates of organic anion transporting polypeptide 2B1 (OATP2B1), such as statin drugs. Maralixibat is an inhibitor of the OATP2B1 transporter in vitro. A decrease in the oral absorption of drugs that rely on OATP2B1-mediated uptake in the gastrointestinal tract may occur when administered with maralixibat. In clinical studies, coadministration of maralixibat (4.75 mg once daily in the morning) with daily evening doses of simvastatin, lovastatin, or atorvastatin did not result in clinically relevant effects on the pharmacokinetics of these statin drugs or their metabolites. However, the effect of maralixibat on the pharmacokinetics of OATP2B1substrate drugs at higher daily doses, such as the maximum recommended daily dose of 28.5 mg (for body weight of 70 kg or more), has not been evaluated in clinical studies.

MANAGEMENT: Until more information is available, caution is advised if maralixibat is used concomitantly with drugs that are substrates of OATP2B1. Dosage adjustments as well as clinical and laboratory monitoring of OATP2B1 substrate drugs may be appropriate whenever maralixibat is added to or withdrawn from therapy.

References

  1. (2021) "Product Information. Livmarli (maralixibat)." Mirum Pharmaceuticals, Inc.

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Drug and food interactions

Moderate

fexofenadine food

Applies to: Allegra-D 24 Hour Allergy & Congestion (fexofenadine / pseudoephedrine)

GENERALLY AVOID: Coadministration with large amounts of certain fruit juices, including grapefruit, orange and apple, may decrease the oral bioavailability of fexofenadine. The proposed mechanism is inhibition of drug efflux via intestinal organic anion transporting polypeptides (e.g., P-glycoprotein), of which fexofenadine is a substrate. In a five-way crossover study with 10 healthy volunteers, 1/4-strength grapefruit juice, grapefruit juice, orange juice and apple juice (300 mL with drug administration and 150 mL every 1/2 hour for up to 3 hours, total volume 1.2 L) reduced the mean area under the plasma concentration-time curve (AUC) of a 120 mg dose of fexofenadine by 23%, 67%, 72% and 77%, respectively, compared to water. Mean peak plasma concentration (Cmax) was similarly affected. The clinical significance of these changes is unknown. However, results from studies using histamine-induced skin wheals and flares found that the size of wheal and flare was significantly larger when fexofenadine was administered with either grapefruit or orange juices compared to water.

MANAGEMENT: To maximize plasma levels and therapeutic effects, fexofenadine should be taken with water. In addition, patients should refrain from consuming large amounts of grapefruit, orange, or apple juice.

References

  1. Bailey DG, Dresser GK, Munoz C, Freemar DJ, Kim RB (2001) "Reduction of fexofenadine bioavailability by fruit juices." Clin Pharmacol Ther, 69, PI-82
  2. Dresser GK, Bailey DG, Leake BF, et al. (2002) "Fruit juices inhibit organic anion transporting polypeptide-mediated drug uptake to decrease the oral availability of fexofenadine." Clin Pharmacol Ther, 71, p. 11-20

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Moderate

pseudoephedrine food

Applies to: Allegra-D 24 Hour Allergy & Congestion (fexofenadine / pseudoephedrine)

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.

MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.

References

  1. Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr (1979) "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res, 1, p. 45-52
  2. Cavanaugh JH, Griffith JD, Oates JA (1970) "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther, 11, p. 656
  3. (2001) "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc
  4. (2001) "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals
  5. (2001) "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals
  6. (2001) "Product Information. Focalin (dexmethylphenidate)." Mikart Inc
  7. (2002) "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company
View all 7 references

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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

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