Interactions between Belsomra and Striant
No drug interactions found, but 29 warnings to review for the following 2 drugs:
- Belsomra (suvorexant)
- Striant (testosterone)
Drug interactions
There were no interactions found between Belsomra and Striant. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
suvorexant Food/Lifestyle
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
Disease interactions
28 potential interactions Applies to: 22 conditions, including High Cholesterol, Depression, Underactive Thyroid, Heart Failure, and Benign Prostatic Hyperplasia.
Benign Prostatic Hyperplasia
Major:
Striant
The testosterone in Striant has a major potential interaction with Benign Prostatic Hyperplasia.
The use of androgenic anabolic steroids is contraindicated for male patients with carcinoma of the breast or prostate. Circulating androgens can be converted in peripheral tissues to estrogens and dihydrotestosterone, which may act as promoters of tumor growth in the breast and prostate, respectively. Likewise, androgenic agents may cause enlargement of the prostate and should be used cautiously in patients with or predisposed to prostatic hypertrophy.
Bleeding Disorder
Major:
Striant
The testosterone in Striant has a major potential interaction with Bleeding Disorder.
Androgenic anabolic steroids may cause suppression of clotting factors II, V, VII, and X, and an increase in prothrombin time. Androgen therapy should be administered cautiously in patients with bleeding disorders.
Breast Cancer
Major:
Striant
The testosterone in Striant has a major potential interaction with Breast Cancer.
When treated with androgenic anabolic steroids, patients with metastatic breast cancer may develop hypercalcemia due to osteolysis. Frequent determination of urine and serum calcium levels is recommended during therapy with androgenic agents. If hypercalcemia occurs, therapy should be stopped. The development of hypercalcemia may indicate progression of metastases to the bone.
Breast Cancer, Male
Major:
Striant
The testosterone in Striant has a major potential interaction with Breast Cancer, Male.
The use of androgenic anabolic steroids is contraindicated for male patients with carcinoma of the breast or prostate. Circulating androgens can be converted in peripheral tissues to estrogens and dihydrotestosterone, which may act as promoters of tumor growth in the breast and prostate, respectively. Likewise, androgenic agents may cause enlargement of the prostate and should be used cautiously in patients with or predisposed to prostatic hypertrophy.
Depression
Major:
Belsomra
The suvorexant in Belsomra has a major potential interaction with Depression.
A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of most anxiolytics, sedatives and hypnotics. Some of these changes include decreased inhibition, aggressiveness, agitation, and hallucinations. These drugs can cause or exacerbate mental depression and cause suicidal behavior and ideation. Therapy with these drugs should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.
Diabetes Mellitus
Moderate:
Striant
The testosterone in Striant has a moderate potential interaction with Diabetes Mellitus.
The metabolic effects of androgenic anabolic steroids may lower blood glucose. Decreased glucose tolerance and increased insulin resistance have also been reported. Patients with diabetes mellitus should be monitored more closely during therapy with androgenic agents, and their antidiabetic regimen adjusted accordingly.
Fluid Retention
Major:
Striant
The testosterone in Striant has a major potential interaction with Fluid Retention.
Androgenic anabolic steroids may cause sodium and water retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with fluid overload or are at risk for developing edema. The manufacturers consider the use of androgenic agents to be contraindicated in patients with severe cardiac, renal and/or hepatic dysfunction.
Glaucoma/Intraocular Hypertension
Moderate:
Belsomra
The suvorexant in Belsomra has a moderate potential interaction with Glaucoma/Intraocular Hypertension.
Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.
Heart Failure
Major:
Striant
The testosterone in Striant has a major potential interaction with Heart Failure.
Androgenic anabolic steroids may cause sodium and water retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with fluid overload or are at risk for developing edema. The manufacturers consider the use of androgenic agents to be contraindicated in patients with severe cardiac, renal and/or hepatic dysfunction.
High Cholesterol
Major:
Striant
The testosterone in Striant has a major potential interaction with High Cholesterol.
Androgenic anabolic steroids may adversely affect serum lipids, including lowering HDL and elevating LDL levels. These changes can be marked, particularly with the 17-alpha-alkyl derivatives (i.e., fluoxymesterone, methyltestosterone, oxandrolone, oxymetholone, and stanozolol), and may significantly impact the risk of atherosclerosis and coronary artery disease. Patients with preexisting hyperlipoproteinemia may require closer monitoring during therapy with androgenic agents, and adjustments made accordingly in their lipid-lowering regimen. Androgen therapy should be administered cautiously in patients with coronary artery disease or a history of ischemic heart disease.
Hypercalcemia
Moderate:
Striant
The testosterone in Striant has a moderate potential interaction with Hypercalcemia.
Androgenic anabolic steroids decrease urinary excretion of calcium, which may result in hypercalcemia. Therapy with androgenic agents should be administered cautiously in patients with hypercalcemia, disorders of bone metabolism such as hyperparathyroidism, or renal dysfunction. Some manufacturers consider the use of androgenic anabolic steroids to be contraindicated in patients with hypercalcemia.
Hyperparathyroidism
Moderate:
Striant
The testosterone in Striant has a moderate potential interaction with Hyperparathyroidism.
Androgenic anabolic steroids decrease urinary excretion of calcium, which may result in hypercalcemia. Therapy with androgenic agents should be administered cautiously in patients with hypercalcemia, disorders of bone metabolism such as hyperparathyroidism, or renal dysfunction. Some manufacturers consider the use of androgenic anabolic steroids to be contraindicated in patients with hypercalcemia.
Hyperthyroidism
Minor:
Striant
The testosterone in Striant has a minor potential interaction with Hyperthyroidism.
When androgenic anabolic steroids are used in patients with thyroid disorders, clinicians should be aware that these agents may affect thyroid function tests. Specifically, thyroid-binding globulin levels may be decreased, resulting in lower total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged, however.
Ischemic Heart Disease
Major:
Striant
The testosterone in Striant has a major potential interaction with Ischemic Heart Disease.
Androgenic anabolic steroids may adversely affect serum lipids, including lowering HDL and elevating LDL levels. These changes can be marked, particularly with the 17-alpha-alkyl derivatives (i.e., fluoxymesterone, methyltestosterone, oxandrolone, oxymetholone, and stanozolol), and may significantly impact the risk of atherosclerosis and coronary artery disease. Patients with preexisting hyperlipoproteinemia may require closer monitoring during therapy with androgenic agents, and adjustments made accordingly in their lipid-lowering regimen. Androgen therapy should be administered cautiously in patients with coronary artery disease or a history of ischemic heart disease.
Liver Disease
Major:
Striant
The testosterone in Striant has a major potential interaction with Liver Disease.
Androgenic anabolic steroids may cause sodium and water retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with fluid overload or are at risk for developing edema. The manufacturers consider the use of androgenic agents to be contraindicated in patients with severe cardiac, renal and/or hepatic dysfunction.
Major:
Striant
The testosterone in Striant has a major potential interaction with Liver Disease.
The use of testosterone is contraindicated in patients with serious hepatic or renal disease.
Major:
Striant
The testosterone in Striant has a major potential interaction with Liver Disease.
The use of androgenic anabolic steroids may be associated with development of cholestatic hepatitis and jaundice. Other, more serious hepatotoxicities such as peliosis hepatis and hepatocellular neoplasms are rare but may occur with prolonged use or high dosages. These latter toxicities may be fatal and often not recognized until they become life-threatening. Patients with preexisting liver diseases should be monitored more closely during therapy with anabolic steroids if they are used. If liver function declines or toxicity occurs, therapy should be withdrawn and the cause investigated.
Moderate:
Belsomra
The suvorexant in Belsomra has a moderate potential interaction with Liver Disease.
In general, anxiolytics, sedatives and hypnotics are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with these drugs should be administered cautiously in patients with liver disease (some are not recommended in severe liver impairment), and the dosage should be adjusted accordingly. Laboratory testing is recommended prior and during treatment.
Narcolepsy
Major:
Belsomra
The suvorexant in Belsomra has a major potential interaction with Narcolepsy.
The use of suvorexant is contraindicated in patient with narcolepsy.
Polycythemia
Major:
Striant
The testosterone in Striant has a major potential interaction with Polycythemia.
Androgenic anabolic steroids may cause polycythemia when given in high dosages or for prolonged periods. Patients with preexisting polycythemia may experience worsening of their condition. Frequent monitoring of clinical status and hemoglobin and hematocrit levels is recommended if androgen therapy is administered to these patients.
Prostate Cancer
Major:
Striant
The testosterone in Striant has a major potential interaction with Prostate Cancer.
The use of androgenic anabolic steroids is contraindicated for male patients with carcinoma of the breast or prostate. Circulating androgens can be converted in peripheral tissues to estrogens and dihydrotestosterone, which may act as promoters of tumor growth in the breast and prostate, respectively. Likewise, androgenic agents may cause enlargement of the prostate and should be used cautiously in patients with or predisposed to prostatic hypertrophy.
Pulmonary Impairment
Major:
Belsomra
The suvorexant in Belsomra has a major potential interaction with Pulmonary Impairment.
Suvorexant has respiratory depressant effects and should be used with caution in patients with compromised respiratory function. Suvorexant has not been studied in patients with severe sleep apnea and severe COPD and should not be used in these patients.
Renal Dysfunction
Major:
Belsomra
The suvorexant in Belsomra has a major potential interaction with Renal Dysfunction.
Some anxiolytic, sedative and hypnotic drugs have not been studied in patients with severe renal impairment and should not be used on these patients.
Major:
Striant
The testosterone in Striant has a major potential interaction with Renal Dysfunction.
The use of testosterone is contraindicated in patients with serious hepatic or renal disease.
Major:
Striant
The testosterone in Striant has a major potential interaction with Renal Dysfunction.
Androgenic anabolic steroids may cause sodium and water retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with fluid overload or are at risk for developing edema. The manufacturers consider the use of androgenic agents to be contraindicated in patients with severe cardiac, renal and/or hepatic dysfunction.
Moderate:
Striant
The testosterone in Striant has a moderate potential interaction with Renal Dysfunction.
Androgenic anabolic steroids decrease urinary excretion of calcium, which may result in hypercalcemia. Therapy with androgenic agents should be administered cautiously in patients with hypercalcemia, disorders of bone metabolism such as hyperparathyroidism, or renal dysfunction. Some manufacturers consider the use of androgenic anabolic steroids to be contraindicated in patients with hypercalcemia.
Underactive Thyroid
Minor:
Striant
The testosterone in Striant has a minor potential interaction with Underactive Thyroid.
When androgenic anabolic steroids are used in patients with thyroid disorders, clinicians should be aware that these agents may affect thyroid function tests. Specifically, thyroid-binding globulin levels may be decreased, resulting in lower total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged, however.
Urinary Retention
Moderate:
Belsomra
The suvorexant in Belsomra has a moderate potential interaction with Urinary Retention.
Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.
More resources
Belsomra
A total of 518 drugs are known to interact with Belsomra.
- Belsomra is in the drug class miscellaneous anxiolytics, sedatives and hypnotics.
- Belsomra is used to treat Insomnia.
Striant
A total of 196 drugs are known to interact with Striant.
- Striant is in the drug class androgens and anabolic steroids.
- Striant is used to treat Hypogonadism, Male.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.