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Drug Interactions between apremilast and Sustiva

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

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Interactions between your drugs

Moderate

efavirenz apremilast

Applies to: Sustiva (efavirenz) and apremilast

MONITOR: Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of apremilast, which is primarily metabolized by the isoenzyme in vitro. According to the product labeling, administration of a single 30 mg oral dose of apremilast with the potent CYP450 inducer rifampin (600 mg once daily for 15 days) resulted in decreases of apremilast peak plasma concentration (Cmax) and systemic exposure (AUC) by 43% and 72%, respectively.

MANAGEMENT: The possibility of a diminished therapeutic response to apremilast should be considered during coadministration with CYP450 3A4 inducers. Pharmacologic effects of apremilast should be monitored more closely following the initiation or withdrawal of a CYP450 3A4 inducer.

References

  1. "Product Information. Otezla (apremilast)." Celgene Corporation (2014):

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Drug and food interactions

Moderate

efavirenz food

Applies to: Sustiva (efavirenz)

ADJUST DOSING INTERVAL: Administration with food increases the plasma concentrations of efavirenz and may increase the frequency of adverse reactions. According to the product labeling, administration of efavirenz capsules (600 mg single dose) with a high-fat/high-caloric meal (894 kcal, 54 g fat, 54% calories from fat) or a reduced-fat/normal-caloric meal (440 kcal, 2 g fat, 4% calories from fat) was associated with mean increases of 39% and 51% in efavirenz peak plasma concentration (Cmax) and 22% and 17% in systemic exposure (AUC), respectively, compared to administration under fasted conditions. For efavirenz tablets, administration of a single 600 mg dose with a high-fat/high-caloric meal (approximately 1000 kcal, 500-600 kcal from fat) resulted in a 79% increase in mean Cmax and a 28% increase in mean AUC of efavirenz relative to administration under fasted conditions.

MANAGEMENT: Efavirenz should be taken on an empty stomach, preferably at bedtime. Dosing at bedtime may improve the tolerability of nervous system symptoms such as dizziness, insomnia, impaired concentration, somnolence, abnormal dreams and hallucinations, although they often resolve on their own after the first 2 to 4 weeks of therapy . Patients should be advised of the potential for additive central nervous system effects when efavirenz is used concomitantly with alcohol or psychoactive drugs, and to avoid driving or operating hazardous machinery until they know how the medication affects them.

References

  1. "Product Information. Sustiva (efavirenz)." DuPont Pharmaceuticals PROD (2001):

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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.

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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