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Drug Interactions between Belsomra and propofol

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

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Interactions between your drugs

Moderate

propofol suvorexant

Applies to: propofol and Belsomra (suvorexant)

MONITOR: Additive central nervous system and cardiorespiratory depressant effects may occur when fospropofol or propofol is administered with other depressants such as sedative-hypnotic agents and narcotic analgesics.

MANAGEMENT: Patients should be monitored closely for excessive sedation and cardiorespiratory depression, and the medication dosage(s) adjusted accordingly. Supportive therapy should be provided if needed.

References

  1. McClune S, McKay AC, Wright PM, et al. (1992) "Synergistic interaction between midazolam and propofol." Br J Anaesth, 69, p. 240-5
  2. Gill SS, Wright EM, Reilly CS (1990) "Pharmacokinetic interaction of propofol and fentanyl: single bolus injection study." Br J Anaesth, 65, p. 760-5
  3. (2001) "Product Information. Diprivan (propofol)." Astra-Zeneca Pharmaceuticals
  4. Pavlin DJ, Coda B, Shen DD, et al. (1996) "Effects of combining propofol and alfentanil on ventilation, analgesia, sedation, and emesis in human volunteers." Anesthesiology, 84, p. 23-37
  5. Hamaoka N, Oda Y, Hase I, Mizutani K, Nakamoto T, Ishizaki T, Asada A (1999) "Propofol decreases the clearance of midazolam by inhibiting CYP3A4: An in vivo and in vitro study." Clin Pharmacol Ther, 66, p. 110-7
  6. (2008) "Product Information. Lusedra (fospropofol)." Eisai Inc
View all 6 references

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Drug and food interactions

Moderate

propofol food

Applies to: propofol

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

suvorexant food

Applies to: Belsomra (suvorexant)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of suvorexant. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills. In addition, alcohol may increase the risk of cognitive and complex behavioral changes associated with the use of hypnotics including suvorexant, such as amnesia, anxiety, hallucinations, sleep-driving, and other neuropsychiatric symptoms.

ADJUST DOSE: Grapefruit juice may significantly increase the plasma concentrations of suvorexant. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit.

ADJUST DOSING INTERVAL: Administration with or soon after a meal may delay the gastrointestinal absorption of suvorexant. According to the product labeling, administration of suvorexant with a high-fat meal resulted in no meaningful change in peak plasma concentration (Cmax) or systemic exposure (AUC), but a delay in Tmax of approximately 1.5 hours.

MANAGEMENT: Concomitant use of suvorexant with alcohol should be avoided. Patients should be advised not to use suvorexant if they had alcohol that evening or before bed. Grapefruit juice should preferably be avoided; otherwise, the recommended dose of suvorexant is 5 mg when used with grapefruit juice and should not exceed 10 mg. Suvorexant may be taken with or without food; however, for faster sleep onset, suvorexant should not be administered with or soon after a meal.

References

  1. (2014) "Product Information. Belsomra (suvorexant)." Merck & Co., 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

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