Can you take Arcapta with Fexinidazole?

Fexinidazole has a moderate potential interaction with Alcoholism.

Nitroimidazoles (e.g., metronidazole, tinidazole, fexinidazole, secnidazole) may inhibit alcohol dehydrogenase and occasionally precipitate a disulfiram-like reaction in patients who consume alcohol while being treated. Symptoms may include abdominal cramps, nausea, vomiting, headache, flushing, rash, weakness, diarrhea, abdominal pain, dizziness, sweating, and hypotension. Patients should be instructed to avoid alcohol-containing products during nitroimidazole therapy and for at least 48 hours (fexinidazole, secnidazole) to 72 hours (metronidazole, tinidazole) after the last dose. Therapy with nitroimidazoles should be administered cautiously in patients who might be prone to acute alcohol intake. An alternative therapy may be appropriate.

Fexinidazole has a moderate potential interaction with Arrhythmia.

Fexinidazole prolongs the QT interval in a concentration-dependent manner; treatment with fexinidazole caused an average increase of 19 msec in the QTcF interval (corrected QT interval by Fridericia). Fexinidazole should be avoided in patients who have: QTcF interval greater than 470 msec; history of torsade de pointes, congenital long QT syndrome, cardiac arrhythmias, uncompensated heart failure, or family history of sudden death; uncorrected hypokalemia.

Fexinidazole has a moderate potential interaction with Depression.

In a clinical trial, adult patients treated with fexinidazole reported a higher percentage of CNS and psychiatric-related side effects than those treated with nifurtimox-eflornithine combination therapy (NECT). Increased incidence of insomnia, headache, and tremor was observed in patients treated with fexinidazole compared to NECT. In the same trial, side effects signifying mood changes and psychiatric disorders (e.g., agitation, anxiety, abnormal behavior, depression, nightmares, hallucination, personality change) were more common with fexinidazole compared to NECT; suicidal ideation was also seen with fexinidazole. In patients with current or history of psychiatric disorders, alternative therapy or increased monitoring of the patient (including hospitalization) should be considered.

The indacaterol in Arcapta has a moderate potential interaction with Diabetes Mellitus.

Adrenergic bronchodilators may cause increases in blood glucose concentrations. These effects are usually transient and slight, but may be significant with dosages higher than those normally recommended. Large doses of IV albuterol (not commercially available in the U.S.) and terbutaline sulfate have been reported to cause exacerbation of preexisting diabetes mellitus and ketoacidosis. Therapy with adrenergic bronchodilators should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.

The indacaterol in Arcapta has a moderate potential interaction with Heart Disease.

Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.

Fexinidazole has a moderate potential interaction with Heart Failure.

Fexinidazole prolongs the QT interval in a concentration-dependent manner; treatment with fexinidazole caused an average increase of 19 msec in the QTcF interval (corrected QT interval by Fridericia). Fexinidazole should be avoided in patients who have: QTcF interval greater than 470 msec; history of torsade de pointes, congenital long QT syndrome, cardiac arrhythmias, uncompensated heart failure, or family history of sudden death; uncorrected hypokalemia.

The indacaterol in Arcapta has a moderate potential interaction with High Blood Pressure.

Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.

The indacaterol in Arcapta has a moderate potential interaction with Hyperthyroidism.

Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.

The indacaterol in Arcapta has a moderate potential interaction with Hypokalemia.

Adrenergic bronchodilators may cause decreases in serum potassium concentrations, primarily when given by nebulization or intravenous administration. Although this effect is usually transient and does not require supplementation, clinically significant hypokalemia may occur in some patients, with the potential to induce cardiovascular adverse effects. The relevance of these observations to oral or oral aerosol/powder for inhalation therapy is unknown. Therapy with adrenergic bronchodilators should be administered cautiously in patients with or predisposed to hypokalemia.

Fexinidazole has a moderate potential interaction with Hypokalemia.

Fexinidazole prolongs the QT interval in a concentration-dependent manner; treatment with fexinidazole caused an average increase of 19 msec in the QTcF interval (corrected QT interval by Fridericia). Fexinidazole should be avoided in patients who have: QTcF interval greater than 470 msec; history of torsade de pointes, congenital long QT syndrome, cardiac arrhythmias, uncompensated heart failure, or family history of sudden death; uncorrected hypokalemia.

Fexinidazole has a major potential interaction with Liver Disease.

Fexinidazole is contraindicated in patients with liver dysfunction since it is extensively metabolized by the liver. However, the pharmacokinetics of fexinidazole in patients with liver dysfunction is unknown. Liver-related laboratory tests should be evaluated at the start and during therapy with fexinidazole. Patients who develop abnormal liver-related laboratory tests during treatment with fexinidazole should be monitored.

Fexinidazole has a moderate potential interaction with Psychosis.

In a clinical trial, adult patients treated with fexinidazole reported a higher percentage of CNS and psychiatric-related side effects than those treated with nifurtimox-eflornithine combination therapy (NECT). Increased incidence of insomnia, headache, and tremor was observed in patients treated with fexinidazole compared to NECT. In the same trial, side effects signifying mood changes and psychiatric disorders (e.g., agitation, anxiety, abnormal behavior, depression, nightmares, hallucination, personality change) were more common with fexinidazole compared to NECT; suicidal ideation was also seen with fexinidazole. In patients with current or history of psychiatric disorders, alternative therapy or increased monitoring of the patient (including hospitalization) should be considered.

Fexinidazole has a moderate potential interaction with Renal Dysfunction.

The use of fexinidazole should be avoided in patients with severe renal dysfunction (estimated GFR less than 30 mL/min/1.73 m2); the pharmacokinetics of fexinidazole in patients with severe renal dysfunction is unknown. No dosage adjustment is necessary for patients with mild to moderate renal dysfunction.

The indacaterol in Arcapta has a moderate potential interaction with Seizures.

Adrenergic bronchodilators may cause CNS stimulation. Therapy with adrenergic bronchodilators should be administered cautiously in patients with seizure disorders. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.