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Drug Interactions between atropine / phenobarbital and iptacopan

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

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Interactions between your drugs

Moderate

PHENobarbital iptacopan

Applies to: atropine / phenobarbital and iptacopan

MONITOR: Coadministration with inducers of CYP450 2C8, uridine diphosphate glucuronosyltransferase (UGT) 1A1, P-glycoprotein (P-gp), breast cancer resistance protein (BCRP), and/or organic anion transporting polypeptide (OATP) 1B1/3 (e.g., rifampin) may decrease iptacopan plasma concentrations and may result in a loss of efficacy. The proposed mechanism is induction of CYP450 2C8-mediated metabolism of iptacopan, which is primarily metabolized by the isoenzyme, glucuronidation via UGT1A1, which is a minor elimination pathway, and the transporters P-gp, BCRP, and OATP1B1/3, for which iptacopan is a substrate. However, clinical data evaluating the interaction are not available.

MANAGEMENT: The potential for diminished pharmacologic effects of iptacopan should be considered during coadministration with CYP450 2C8, UGT1A1, P-gp, BCRP, and/or OATP1B1/3 inducers. The manufacturer recommends the pharmacologic effects of iptacopan should be monitored more closely, and the CYP450 2C8 inducer be discontinued if loss of therapeutic efficacy occurs. Additionally, the pharmacologic response to iptacopan should be monitored more closely whenever a CYP450 2C8 inducer is added to or withdrawn from therapy.

References (3)
  1. (2024) "Product Information. Fabhalta (iptacopan)." Novartis Pharmaceuticals Australia Pty Ltd
  2. (2024) "Product Information. Fabhalta (iptacopan)." Novartis Pharmaceuticals, SUPPL-1
  3. Novartis Pharmaceuticals Canada Inc Product Monograph. Fabhalta (iptacopan) https://pdf.hres.ca/dpd_pm/00078186.PDF

Drug and food interactions

Major

PHENobarbital food

Applies to: atropine / phenobarbital

GENERALLY AVOID: Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.

MANAGEMENT: The combination of ethanol and barbiturates should be avoided.

References (5)
  1. Gupta RC, Kofoed J (1966) "Toxological statistics for barbiturates, other sedatives, and tranquilizers in Ontario: a 10-year survey." Can Med Assoc J, 94, p. 863-5
  2. Misra PS, Lefevre A, Ishii H, Rubin E, Lieber CS (1971) "Increase of ethanol, meprobamate and pentobarbital metabolism after chronic ethanol administration in man and in rats." Am J Med, 51, p. 346-51
  3. Saario I, Linnoila M (1976) "Effect of subacute treatment with hypnotics, alone or in combination with alcohol, on psychomotor skills related to driving." Acta Pharmacol Toxicol (Copenh), 38, p. 382-92
  4. Stead AH, Moffat AC (1983) "Quantification of the interaction between barbiturates and alcohol and interpretation of fatal blood concentrations." Hum Toxicol, 2, p. 5-14
  5. Seixas FA (1979) "Drug/alcohol interactions: avert potential dangers." Geriatrics, 34, p. 89-102
Moderate

atropine food

Applies to: atropine / phenobarbital

GENERALLY AVOID: Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous. In addition, the potential for abuse may be increased with the combination. The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system. No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load. However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.

MANAGEMENT: Alcohol should generally be avoided during therapy with anticholinergic agents. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.

References (1)
  1. Linnoila M (1973) "Drug effects on psychomotor skills related to driving: interaction of atropine, glycopyrrhonium and alcohol." Eur J Clin Pharmacol, 6, p. 107-12

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.

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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

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