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Drug Interactions between Banzel and quetiapine

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

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Interactions between your drugs

Moderate

QUEtiapine rufinamide

Applies to: quetiapine and Banzel (rufinamide)

MONITOR: Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of quetiapine, which is primarily metabolized by the isoenzyme. In 18 psychiatric patients receiving quetiapine 300 mg twice daily, addition of the potent CYP450 3A4 inducer carbamazepine (200 mg three times daily) decreased mean quetiapine peak plasma concentration (Cmax) and systemic exposure (AUC) by 80% and 87%, respectively, and increased oral clearance (Cl/F) by 7.5-fold compared to quetiapine administered alone. The interaction has also been reported with phenytoin, another potent CYP450 3A4 inducer. In ten subjects with various affective disorders, coadministration of quetiapine (250 mg orally three times a day) with phenytoin (100 mg orally three times a day) decreased the mean steady-state Cmax, trough plasma concentration (Cmin) and AUC of quetiapine by 66%, 89% and 80%, respectively. The mean oral clearance increased by 5.5-fold. No data are available for other, less potent CYP450 3A4 inducers.

MANAGEMENT: Pharmacologic response to quetiapine should be monitored more closely whenever a CYP450 3A4 inducer is added to or withdrawn from therapy, and the quetiapine dosage adjusted as necessary. Patients should be advised to notify their physician if their symptoms worsen or their condition changes.

References (5)
  1. (2001) "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals
  2. (1997) "Quetiapine for schizophrenia." Med Lett Drugs Ther, 39, p. 117-8
  3. Wong YWJ, Yeh C, Thyrum PT (2001) "The effects of concomitant phenytoin administration on the steady-state pharmacokinetics of quetiapine." J Clin Psychopharmacol, 21, p. 89-93
  4. Grimm SW, Richtand NM, Winter HR, Stams KR, Reele SB (2006) "Effects of cytochrome P450 3A modulators ketoconazole and carbamazepine on quetiapine pharmacokinetics." Br J Clin Pharmacol, 61, p. 58-69
  5. Cerner Multum, Inc. "Australian Product Information."

Drug and food interactions

Moderate

rufinamide food

Applies to: Banzel (rufinamide)

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

ADJUST DOSING INTERVAL: Food enhances the oral absorption and bioavailability of rufinamide. In healthy volunteers, administration of a single 400 mg dose of rufinamide with food resulted in an approximately 56% increase in mean peak plasma concentration (Cmax) and a 34% increase in systemic exposure (AUC) compared to administration during a fasting state.

MANAGEMENT: To ensure maximal oral absorption, it is preferable to administer rufinamide with food. Patients receiving rufinamide should be advised to avoid consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how rufinamide affects them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References (1)
  1. (2008) "Product Information. Banzel (rufinamide)." Eisai Inc

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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