Drug Interactions between benzgalantamine and daridorexant

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with daridorexant may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) efflux transporter and/or the CYP450 3A4 isoenzyme. The mechanism is inhibition of CYP450 3A4 and P-gp mediated drug efflux by daridorexant. Substrates of P-gp and/or CYP450 3A4 that are also inhibitors of CYP450 3A4 may also increase the plasma concentrations of daridorexant, a CYP450 3A4 substrate. When co-administered with daridorexant 50 mg, the systemic exposure (AUC) and peak plasma concentration (Cmax) of dabigatran etexilate, a sensitive P-gp substrate, increased by 42% and 29%, respectively, suggesting mild P-gp inhibition. Likewise, the AUC and Cmax of midazolam, a sensitive CYP450 3A4 substrate, increased by 42% and 13%, respectively, in subjects receiving 50 mg of daridorexant. However, the pharmacokinetics of midazolam were not affected by 25 mg of daridorexant.

MANAGEMENT: Caution is advised when daridorexant is used with drugs that are substrates of P-gp and/or CYP450 3A4, particularly those with a narrow therapeutic index, as well as with CYP450 3A4 substrates that are also CYP450 3A4 inhibitors (e.g., ethinyl estradiol, hydroxychloroquine, nicardipine, nifedipine). Pharmacologic response to the coadministered P-gp and/or CYP450 3A4 substrate(s) and daridorexant should be monitored more closely whenever daridorexant is added to or withdrawn from therapy. Individual product labeling for the CYP450 3A4 and/or P-gp substrate(s) should be consulted for further guidance.