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Drug Interactions between atazanavir and Celexa

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

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Interactions between your drugs

Minor

citalopram atazanavir

Applies to: Celexa (citalopram) and atazanavir

Coadministration with inhibitors of CYP450 3A4 is not expected to significantly affect the pharmacokinetics of citalopram or escitalopram, both of which are partially metabolized by the isoenzyme. Administration of racemic citalopram (40 mg) in combination with the potent CYP450 3A4 inhibitor ketoconazole (200 mg) decreased the ketoconazole peak plasma concentration (Cmax) by 21% and systemic exposure (AUC) by 10%, but did not significantly affect the pharmacokinetics of citalopram. Likewise, coadministration of a single 20 mg dose of escitalopram with a single 600 mg dose of ritonavir, another potent CYP450 3A4 inhibitor, did not affect the pharmacokinetics of either drug. Because citalopram and escitalopram are both metabolized by multiple isoenzymes (CYP450 2C19, 3A4, and 2D6), inhibition of a single isoenzyme may not appreciably decrease their clearance.

References

  1. (2001) "Product Information. Celexa (citalopram)." Forest Pharmaceuticals
  2. (2002) "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals

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Drug and food interactions

Moderate

citalopram food

Applies to: Celexa (citalopram)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
View all 4 references

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Moderate

atazanavir food

Applies to: atazanavir

ADJUST DOSING INTERVAL: Administration of atazanavir with food enhances oral bioavailability and reduces pharmacokinetic variability. According to the manufacturer, administration with a light meal increased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of a single 400 mg dose of atazanavir by 57% and 70%, respectively, relative to the fasting state. Administration with a high-fat meal resulted in a mean increase of 35% in atazanavir AUC and no change in Cmax compared to fasting. The coefficient of variation of AUC and Cmax decreased by approximately one-half when given with either a light or high-fat meal compared to the fasting state.

MANAGEMENT: To ensure maximal oral absorption, atazanavir should be administered with or immediately after a meal.

References

  1. (2003) "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb

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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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