Drug Interactions between arimoclomol and Pronestyl

MONITOR: Arimoclomol may increase the systemic exposure and effects of organic cation transporter 2 (OCT2) substrates via inhibition of this renal uptake transporter. Clinical trials of arimoclomol done in patients with Niemann-Pick disease type C (NPC), healthy subjects, and patients with other diseases have observed mean increases in the endogenous substrate creatinine of 10% to 20% compared to baseline. One study in healthy male subjects (n=16) who received arimoclomol (744 mg/day for 28 days) observed a reversible increase in the mean serum creatinine of 19% after 21 days of treatment, without any effects on glomerular function. These increases may be due to inhibition of renal tubular secretion transporters.

MANAGEMENT: Caution and clinical monitoring are advised if arimoclomol is used in combination with an organic cation transporter 2 (OCT2) substrate. The labeling of the substrate should be consulted for specific monitoring, dose adjustment, and discontinuation recommendations should adverse reactions result from this combination. A reduction in the dose of the substrate may be necessary.