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Drug Interactions between bepridil and ivacaftor / lumacaftor

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

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Interactions between your drugs

Major

bepridil ivacaftor

Applies to: bepridil and ivacaftor / lumacaftor

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of most calcium channel blockers (CCBs), as CYP450 3A4 is the primary isoenzyme responsible for their metabolism. Some drug interaction studies have reported a significant reduction in plasma levels for certain CCBs. For example, when a single dose of nimodipine (60 mg) was administered to patients with epilepsy (n=8) who were also receiving chronic treatment with a potent CYP450 3A4-inducing antiepileptic agent (phenytoin, phenobarbital and/or carbamazepine), the mean areas under the plasma nimodipine concentration curve (AUC) were lowered by about 7-fold compared to the control group. In another drug interaction study comparing nisoldipine pharmacokinetics in epileptic patients on concurrent phenytoin therapy (n=12) to healthy controls (n=12), the AUC of nisoldipine was approximately 90% lower (1.6 vs 15.2 mcg/L/h) in patients on concomitant phenytoin therapy. Clinical data for all calcium channel blockers with potent CYP450 3A4 inducers are not available.

MANAGEMENT: Concomitant use of calcium channel blockers (CCBs) primarily metabolized by CYP450 3A4 with potent CYP450 3A4 inducers should generally be avoided. Additional monitoring and dose adjustments may be required if coadministration is necessary, particularly during initiation, titration, or discontinuation of the CYP450 3A4 inducer. Individual product labeling for the CCB should be consulted for further guidance.

Major

bepridil lumacaftor

Applies to: bepridil and ivacaftor / lumacaftor

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of most calcium channel blockers (CCBs), as CYP450 3A4 is the primary isoenzyme responsible for their metabolism. Some drug interaction studies have reported a significant reduction in plasma levels for certain CCBs. For example, when a single dose of nimodipine (60 mg) was administered to patients with epilepsy (n=8) who were also receiving chronic treatment with a potent CYP450 3A4-inducing antiepileptic agent (phenytoin, phenobarbital and/or carbamazepine), the mean areas under the plasma nimodipine concentration curve (AUC) were lowered by about 7-fold compared to the control group. In another drug interaction study comparing nisoldipine pharmacokinetics in epileptic patients on concurrent phenytoin therapy (n=12) to healthy controls (n=12), the AUC of nisoldipine was approximately 90% lower (1.6 vs 15.2 mcg/L/h) in patients on concomitant phenytoin therapy. Clinical data for all calcium channel blockers with potent CYP450 3A4 inducers are not available.

MANAGEMENT: Concomitant use of calcium channel blockers (CCBs) primarily metabolized by CYP450 3A4 with potent CYP450 3A4 inducers should generally be avoided. Additional monitoring and dose adjustments may be required if coadministration is necessary, particularly during initiation, titration, or discontinuation of the CYP450 3A4 inducer. Individual product labeling for the CCB should be consulted for further guidance.

Drug and food interactions

Moderate

bepridil food

Applies to: bepridil

Grapefruit juice may increase the blood levels of certain medications such as bepridil. You may want to limit your consumption of grapefruit and grapefruit juice during treatment with bepridil. However, if you have been regularly consuming grapefruit or grapefruit juice with the medication, then it is advisable for you to talk with your doctor before changing the amounts of these products in your diet, as this may alter the effects of your medication. Contact your doctor if your condition changes or you experience increased side effects. Orange juice is not expected to interact.

Moderate

ivacaftor food

Applies to: ivacaftor / lumacaftor

Ivacaftor should be taken with fat-containing foods such as eggs, avocados, nuts, meat, butter, peanut butter, cheese pizza, and whole-milk dairy products to help with its absorption. Do not consume grapefruit juice or any food that contains grapefruit or Seville oranges during treatment with ivacaftor unless directed otherwise by your doctor. Grapefruit juice can significantly increase the blood levels of ivacaftor. This may increase the risk and/or severity of serious side effects such as liver damage. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate

bepridil food

Applies to: bepridil

Bepridil and ethanol (alcohol) may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate

bepridil food

Applies to: bepridil

Using bepridil together with multivitamin with minerals can decrease the effects of bepridil. Talk with your doctor before using bepridil and multivitamin with minerals together. You may need a dose adjustment or need your blood pressure checked more often if you take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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