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Drug Interactions between BuSpar and delavirdine

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

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Interactions between your drugs

Minor

busPIRone delavirdine

Applies to: BuSpar (buspirone) and delavirdine

Serum concentrations and effects of medications that are metabolized by the 3A4 enzymatic pathways may theoretically be elevated in patients receiving delavirdine. The mechanism is inhibition of these enzymes by delavirdine. The clinical significance is unknown. Monitoring for clinical and laboratory evidence of safety and tolerance is recommended. Dosage adjustments or alternatives may be needed if an interaction is suspected.

References (6)
  1. Cheng CL, Smith DE, Carver PL, Cox SR, Watkins PB, Blake DS, Kauffman CA, Meyer KM, Amidon GL, Stetson PL (1997) "Steady-state pharmacokinetics of delavirdine in HIV-positive patients: Effect on erythromycin breath test." Clin Pharmacol Ther, 61, p. 531-43
  2. (2001) "Product Information. Rescriptor (delavirdine)." Pharmacia and Upjohn
  3. Barry M, Mulcahy F, Merry C, Gibbons S, Back D (1999) "Pharmacokinetics and potential interactions amongst antiretroviral agents used to treat patients with HIV infection." Clin Pharmacokinet, 36, p. 289-304
  4. Voorman RL, Maio SM, Payne NA, Zhao Z, Koeplinger KA, Wang X (1998) "Microsomal metabolism of delavirdine: evidence for mechanism-based inactivation of human cytochrome P450 3A." J Pharmacol Exp Ther, 287, p. 381-8
  5. vonMoltke LL, Greenblatt DJ, Granda BW, Giancarlo GM, Duan SX, Daily JP, Harmatz JS, Shader RI (2001) "Inhibition of human cytochrome P450 isoforms by nonnucleoside reverse transcriptase inhibitors." J Clin Pharmacol, 41, p. 85-91
  6. Fichtenbaum CJ, Gerber JG (2002) "Interactions between antiretroviral drugs and drugs used for the therapy of the metabolic complications encountered during HIV infection." Clin Pharmacokinet, 41, p. 1195-211

Drug and food interactions

Moderate

busPIRone food

Applies to: BuSpar (buspirone)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of buspirone. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

ADJUST DOSING INTERVAL: In a small, randomized, crossover study, the consumption of large amounts of grapefruit juice (compared to water) was associated with significantly increased plasma buspirone concentrations, slightly prolonged elimination half-lives, and delayed times to reach peak drug concentration. The perceived pharmacodynamic effect of buspirone, as measured by subjective drowsiness and overall subjective drug effect, was also enhanced by grapefruit juice. These alterations may stem from the delay of gastric emptying as well as inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall induced by certain compounds present in grapefruits.

MANAGEMENT: Patients receiving buspirone should be advised to avoid consumption of alcohol. Patients also should preferably avoid the consumption of large amounts of grapefruits and grapefruit juice to prevent any undue fluctuations in plasma drug levels. If this is not possible, the buspirone dose should be taken at least 2 hours before or 8 hours after grapefruit or grapefruit juice. Monitoring for increased CNS depression is recommended.

References (3)
  1. (2002) "Product Information. Buspar (buspirone)." Bristol-Myers Squibb
  2. Lilja JJ, Kivisto KT, Backman JT, Lamberg TS, Neuvonen PJ (1998) "Grapefruit juice substantially increases plasma concentrations of buspirone." Clin Pharmacol Ther, 64, p. 655-60
  3. Bailey DG, Dresser GR, Kreeft JH, Munoz C, Freeman DJ, Bend JR (2000) "Grapefruit-felodipine interaction: Effect of unprocessed fruit and probable active ingredients." Clin Pharmacol Ther, 68, p. 468-77

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

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