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Drug Interactions between bilberry / evening primrose / flax and ganaxolone

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

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Interactions between your drugs

Minor

evening primrose ganaxolone

Applies to: bilberry / evening primrose / flax and ganaxolone

Some clinicians have suggested that evening primrose and borage oil, both of which contain the omega-6 fatty acid gamma linolenic acid, may lower the seizure threshold and antagonize the effects of anticonvulsants. However, data regarding the effect of gamma linolenic acid on seizure threshold are conflicting and limited. The possibility of an interaction should be considered if loss of seizure control occurs in patients taking evening primrose or borage oil.

References (4)
  1. Miller LG (1998) "Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions." Arch Intern Med, 158, p. 2200-11
  2. Therapeutic Research Faculty (2008) Natural Medicines Comprehensive Database. http://www.naturaldatabase.com
  3. N. A. Michael Eskin (2008) "Borage and evening primrose oil." European Journal of Lipid Science and Technology, 110, p. 1
  4. Asadi-Samani M, Bahmani M, Rafieian-Kopaei M (2014) "The chemical composition, botanical characteristic and biological activities of Borago officinalis: a review." Asian Pac J Trop Med, 7S1, S22-8

Drug and food interactions

Moderate

ganaxolone food

Applies to: ganaxolone

ADJUST DOSING INTERVAL: Food enhances the oral bioavailability of ganaxolone. When administered with a high-fat meal, ganaxolone peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 3- and 2-fold, respectively, compared to administration under fasted conditions. Ganaxolone was administered with food in the premarketing study population. The efficacy of ganaxolone when administered in the fasted state is unknown.

GENERALLY AVOID: Concomitant use of ganaxolone with central nervous system (CNS) depressants, including alcohol, may potentiate adverse effects such as somnolence and sedation.

MANAGEMENT: Ganaxolone must be administered with food according to the manufacturer. Patients should be advised to avoid or limit consumption of alcohol and to avoid activities requiring mental alertness such as driving or operating hazardous machinery until they know how the medication affects them.

References (1)
  1. (2022) "Product Information. Ztalmy (ganaxolone)." Marinus Pharmaceuticals, 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

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

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