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Drug Interactions between Byvalson and Technivie

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

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Interactions between your drugs

Moderate

ritonavir valsartan

Applies to: Technivie (ombitasvir / paritaprevir / ritonavir) and Byvalson (nebivolol / valsartan)

MONITOR: Coadministration with inhibitors of the hepatic uptake transporter OATP 1B1 (e.g., rifampin, cyclosporine, paritaprevir) or the hepatic efflux transporter MRP2 (e.g., ritonavir) may increase the systemic exposure to valsartan, which is a substrate of both transporters.

MANAGEMENT: Caution is advised if valsartan is used in combination with inhibitors of OATP 1B1 or MRP2. Pharmacologic response and blood pressure should be monitored more closely following the addition, discontinuation, or change of dosage of the transporter inhibitor, and the valsartan dosage adjusted as necessary.

References

  1. "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals PROD (2001):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. "Product Information. Exforge (amlodipine-valsartan)." Novartis Pharmaceuticals (2007):
  4. Cerner Multum, Inc. "Australian Product Information." O 0
  5. "Product Information. Viekira Pak (dasabuvir/ombitasvir/paritaprev/ritonav)." AbbVie US LLC (2022):
  6. "Product Information. Nexlizet (bempedoic acid-ezetimibe)." Esperion Therapeutics (2020):
  7. "Product Information. Nexletol (bempedoic acid)." Esperion Therapeutics (2020):
View all 7 references

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Moderate

ritonavir nebivolol

Applies to: Technivie (ombitasvir / paritaprevir / ritonavir) and Byvalson (nebivolol / valsartan)

MONITOR: Coadministration with ritonavir may increase the plasma concentrations of drugs that are substrates of the CYP450 2D6 isoenzyme. The mechanism is decreased clearance due to competitive inhibition of CYP450 2D6 activity by ritonavir. The systemic exposure (AUC) of some coadministered drugs has been reported to increase by up to twofold.

MANAGEMENT: Caution is advised if ritonavir must be used concurrently with medications that undergo metabolism by CYP450 2D6, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever ritonavir is added to or withdrawn from therapy.

References

  1. "Product Information. Norvir (ritonavir)." Abbott Pharmaceutical PROD (2001):

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Moderate

valsartan nebivolol

Applies to: Byvalson (nebivolol / valsartan) and Byvalson (nebivolol / valsartan)

GENERALLY AVOID: In the Valsartan Heart Failure Trial, the combination of valsartan with a beta-blocker and an ACE inhibitor was associated with unfavorable outcomes on morbidity and mortality in heart failure patients. The mechanism is unknown.

MANAGEMENT: The manufacturer recommends that the triple combination of valsartan with a beta-blocker and an ACE inhibitor be avoided in heart failure patients.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Cerner Multum, Inc. "Australian Product Information." O 0

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Moderate

valsartan paritaprevir

Applies to: Byvalson (nebivolol / valsartan) and Technivie (ombitasvir / paritaprevir / ritonavir)

MONITOR: Coadministration with inhibitors of the hepatic uptake transporter OATP 1B1 (e.g., rifampin, cyclosporine, paritaprevir) or the hepatic efflux transporter MRP2 (e.g., ritonavir) may increase the systemic exposure to valsartan, which is a substrate of both transporters.

MANAGEMENT: Caution is advised if valsartan is used in combination with inhibitors of OATP 1B1 or MRP2. Pharmacologic response and blood pressure should be monitored more closely following the addition, discontinuation, or change of dosage of the transporter inhibitor, and the valsartan dosage adjusted as necessary.

References

  1. "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals PROD (2001):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. "Product Information. Exforge (amlodipine-valsartan)." Novartis Pharmaceuticals (2007):
  4. Cerner Multum, Inc. "Australian Product Information." O 0
  5. "Product Information. Viekira Pak (dasabuvir/ombitasvir/paritaprev/ritonav)." AbbVie US LLC (2022):
  6. "Product Information. Nexlizet (bempedoic acid-ezetimibe)." Esperion Therapeutics (2020):
  7. "Product Information. Nexletol (bempedoic acid)." Esperion Therapeutics (2020):
View all 7 references

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Drug and food interactions

Moderate

ritonavir food

Applies to: Technivie (ombitasvir / paritaprevir / ritonavir)

ADJUST DOSING INTERVAL: Administration with food may modestly affect the bioavailability of ritonavir from the various available formulations. When the oral solution was given under nonfasting conditions, peak ritonavir concentrations decreased 23% and the extent of absorption decreased 7% relative to fasting conditions. Dilution of the oral solution (within one hour of dosing) with 240 mL of chocolate milk or a nutritional supplement (Advera or Ensure) did not significantly affect the extent and rate of ritonavir absorption. When a single 100 mg dose of the tablet was administered with a high-fat meal (907 kcal; 52% fat, 15% protein, 33% carbohydrates), approximately 20% decreases in mean peak concentration (Cmax) and systemic exposure (AUC) were observed relative to administration after fasting. Similar decreases in Cmax and AUC were reported when the tablet was administered with a moderate-fat meal. In contrast, the extent of absorption of ritonavir from the soft gelatin capsule formulation was 13% higher when administered with a meal (615 KCal; 14.5% fat, 9% protein, and 76% carbohydrate) relative to fasting.

MANAGEMENT: Ritonavir should be taken with meals to enhance gastrointestinal tolerability.

References

  1. "Product Information. Norvir (ritonavir)." Abbott Pharmaceutical PROD (2001):

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Moderate

valsartan food

Applies to: Byvalson (nebivolol / valsartan)

GENERALLY AVOID: Moderate-to-high dietary intake of potassium, especially salt substitutes, may increase the risk of hyperkalemia in some patients who are using angiotensin II receptor blockers (ARBs). ARBs can promote hyperkalemia through inhibition of angiotensin II-induced aldosterone secretion. Patients with diabetes, heart failure, dehydration, or renal insufficiency have a greater risk of developing hyperkalemia.

MANAGEMENT: Patients should receive dietary counseling and be advised to not use potassium-containing salt substitutes or over-the-counter potassium supplements without consulting their physician. If salt substitutes are used concurrently, regular monitoring of serum potassium levels is recommended. Patients should also be advised to seek medical attention if they experience symptoms of hyperkalemia such as weakness, irregular heartbeat, confusion, tingling of the extremities, or feelings of heaviness in the legs.

References

  1. "Product Information. Cozaar (losartan)." Merck & Co., Inc PROD (2001):
  2. "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals PROD (2001):

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Moderate

paritaprevir food

Applies to: Technivie (ombitasvir / paritaprevir / ritonavir)

ADJUST DOSING INTERVAL: Food enhances the oral bioavailability of ombitasvir, paritaprevir, ritonavir, and dasabuvir. Relative to fasting conditions, administration of ombitasvir, paritaprevir, ritonavir, and dasabuvir with a moderate-fat meal (approximately 600 Kcal; 20% to 30% calories from fat) increased the mean systemic exposure (AUC) by 82%, 211%, 49%, and 30%, respectively. Relative to fasting conditions, administration of ombitasvir, paritaprevir, ritonavir, and dasabuvir with a high-fat meal (approximately 900 Kcal; with 60% calories from fat) increased the mean AUC by 76%, 180%, 44%, and 22%, respectively.

MANAGEMENT: Ombitasvir/paritaprevir/ritonavir plus dasabuvir should always be administered with a meal. The fat or calorie content does not matter.

References

  1. "Product Information. Viekira Pak (dasabuvir/ombitasvir/paritaprev/ritonav)." AbbVie US LLC (2022):

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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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