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Drug Interactions between Cap-Profen and Korlym

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

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Interactions between your drugs

Moderate

ibuprofen miFEPRIStone

Applies to: Cap-Profen (ibuprofen) and Korlym (mifepristone)

MONITOR: Coadministration with mifepristone may increase the plasma concentrations of drugs that are substrates of CYP450 2C8 and/or 2C9. The mechanism is decreased clearance due to inhibition of CYP450 2C8/2C9 activity by mifepristone. When a single 40 mg dose of fluvastatin, a typical CYP450 2C8/2C9 substrate, was administered with mifepristone 1200 mg once daily for 7 days in healthy subjects, mean fluvastatin peak plasma concentration (Cmax) and systemic exposure (AUC) increased by nearly 1.8- and 3.6-fold, respectively, compared to administration of fluvastatin alone.

MANAGEMENT: Caution is advised if mifepristone must be used concomitantly with medications that are substrates of CYP450 2C8 and/or 2C9, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever mifepristone is added to or withdrawn from therapy. The lowest dosage of sensitive substrates (e.g., repaglinide, warfarin) should be used whenever possible. Because mifepristone is eliminated slowly from the body, drug interactions may be observed for a prolonged period following discontinuation (approximately 2 to 3 weeks if mifepristone had been administered chronically to steady state).

References

  1. "Product Information. Korlym (mifepristone)." Corcept Therapeutics Incorporated (2012):

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Drug and food interactions

Moderate

miFEPRIStone food

Applies to: Korlym (mifepristone)

ADJUST DOSING INTERVAL: Food may significantly increase the plasma concentrations of mifepristone.

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of mifepristone. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Because pharmacokinetic interactions involving grapefruit juice are often subject to a high degree of interpatient variability, the extent to which a given patient may be affected is difficult to predict.

MANAGEMENT: When mifepristone is used daily to control hyperglycemia secondary to hypercortisolism in patients with endogenous Cushing's syndrome, it should be taken with food to achieve consistent plasma drug levels. Patients should be advised to avoid consuming grapefruit or grapefruit juice during treatment with mifepristone, as it may cause increased adverse effects such as headache, dizziness, fatigue, nausea, vomiting, cramping, diarrhea, hypokalemia, adrenal insufficiency, vaginal bleeding, arthralgia, peripheral edema, and hypertension. Because mifepristone is eliminated slowly from the body, the interaction with grapefruit juice may be observed for a prolonged period.

References

  1. "Product Information. Mifeprex (mifepristone)." Danco Laboratories PROD (2001):
  2. "Product Information. Korlym (mifepristone)." Corcept Therapeutics Incorporated (2012):

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Moderate

ibuprofen food

Applies to: Cap-Profen (ibuprofen)

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

References

  1. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn PROD (2002):

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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.


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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.