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Drug Interactions between armodafinil and palovarotene

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

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Interactions between your drugs

Major

armodafinil palovarotene

Applies to: armodafinil and palovarotene

GENERALLY AVOID: Coadministration with moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations and pharmacologic effects of palovarotene, which is primarily metabolized by the isoenzyme. According to product labeling, coadministration with rifampin, a potent CYP450 3A4 inducer, decreased the peak plasma concentration and systemic exposure of palovarotene by 81% and 89%, respectively. Data are not available for palovarotene in combination with other, less potent CYP450 3A4 inducers.

MANAGEMENT: Concomitant use of palovarotene with moderate CYP450 3A4 inducers should generally be avoided due to the potential for loss of therapeutic efficacy. If coadministration cannot be avoided, pharmacologic response to palovarotene should be monitored more closely whenever a CYP450 3A4 inducer is added to or withdrawn from therapy.

References

  1. (2022) "Product Information. Sohonos (palovarotene)." Ipsen Biopharmaceuticals Canada inc, 1
  2. (2023) "Product Information. Sohonos (palovarotene)." Ipsen Biopharmaceuticals, Inc

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Drug and food interactions

Major

palovarotene food

Applies to: palovarotene

GENERALLY AVOID: Grapefruit, pomelo, grapefruit hybrids, and juices or supplements containing these fruits may increase the plasma concentrations of palovarotene. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in these fruits. Inhibition of hepatic CYP450 3A4 may also contribute. The interaction has not been studied with these fruits. Concomitant use of erythromycin, a moderate CYP450 3A4 inhibitor, with palovarotene at steady-state plasma levels increased its peak plasma concentration (Cmax) and systemic exposure (AUC) by 1.6 and 2.5-fold, respectively. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition. Increased concentrations of palovarotene may increase the risk of adverse effects such as dry skin, dry lips, alopecia, pruritus, erythema, paronychia, cellulitis, decubitus ulcer, xerophthalmia, night blindness, depression, mood alterations, and pseudotumour cerebri (benign intracranial hypertension).

ADJUST DOSE: Food increases oral absorption of palovarotene.

MANAGEMENT: The manufacturer advises that concomitant use of palovarotene with grapefruit, pomelo, grapefruit hybrids and juices or supplements containing these fruits should be avoided. To ensure maximal absorption, palovarotene should be administered with food.

References

  1. (2022) "Product Information. Sohonos (palovarotene)." Ipsen Biopharmaceuticals Canada inc, 1
  2. (2023) "Product Information. Sohonos (palovarotene)." Ipsen Biopharmaceuticals, Inc

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Minor

armodafinil food

Applies to: armodafinil

Administration with food may delay the absorption of modafinil (the racemate) and armodafinil (the R-enantiomer) without significantly affecting their overall bioavailability. According to the product labeling, modafinil's absorption may be delayed by approximately one hour if taken with food. Similarly, the time to reach peak plasma concentration (Tmax) of armodafinil may be delayed by approximately 2 to 4 hours in the fed state.

References

  1. (2001) "Product Information. Provigil (modafinil)." Cephalon, Inc
  2. (2007) "Product Information. Nuvigil (armodafinil)." Cephalon Inc

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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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