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Drug Interactions between amoxicillin / clarithromycin / vonoprazan and benzgalantamine

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

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Interactions between your drugs

Moderate

clarithromycin benzgalantamine

Applies to: amoxicillin / clarithromycin / vonoprazan and benzgalantamine

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with potent inhibitors of CYP450 2D6 and/or 3A4 may increase the plasma concentrations of galantamine, which is also an active metabolite of benzgalantamine. Up to 75% of galantamine is eliminated via metabolism and in vitro studies have identified CYP450 2D6 and 3A4 as the major isoenzymes involved. The systemic exposure (AUC) of galantamine (4 mg, 8 mg, or 12 mg twice daily) increased by 40%, 45%, and 48%, respectively, when administered to healthy volunteers (n=16) also receiving the strong CYP450 2D6 inhibitor paroxetine. Similarly, the strong CYP450 3A4 inhibitor ketoconazole (200 mg twice daily) increased the AUC of galantamine (4 mg twice daily) by 30% when given concurrently to study subjects (n=16). An increase in the AUC of galantamine can increase the risk of acetylcholinesterase inhibitor-related adverse effects. One potential side effect of galantamine is bradycardia, which may increase the risk of QT prolongation. If the inhibitor being coadministered is also associated with QT prolongation (e.g., adagrasib, ceritinib, fluoxetine, ketoconazole, levoketoconazole, mifepristone), the risk of experiencing this adverse effect may be further increased.

MANAGEMENT: Caution and closer monitoring of the pharmacologic response to galantamine and its prodrug benzgalantamine is advised whenever a potent CYP450 2D6 and/or 3A4 inhibitor is added to or withdrawn from therapy. Some authorities suggest considering a reduction in the galantamine dose for patients on concurrent potent CYP450 2D6 and/or 3A4 inhibitors. Patients should be monitored more closely for acetylcholinesterase inhibitor related adverse effects including vagotonic effects on the heart rate (e.g., bradycardia, which may increase the risk of QT prolongation, and heart block), neurologic side effects (e.g., seizure activity), respiratory distress, bladder outflow obstruction, dizziness or syncope, nausea, vomiting and diarrhea. These effects may be more severe when the coadministered inhibitor shares a similar adverse effect profile with galantamine.

Minor

amoxicillin clarithromycin

Applies to: amoxicillin / clarithromycin / vonoprazan and amoxicillin / clarithromycin / vonoprazan

Information for this minor interaction is available on the professional version.

Drug and food interactions

Minor

clarithromycin food

Applies to: amoxicillin / clarithromycin / vonoprazan

Information for this minor interaction is available on the professional version.

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.