Drug Interactions between conivaptan and Razadyne ER

MONITOR: Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of galantamine, which is partially metabolized by the isoenzyme. In multiple dose pharmacokinetic studies, a potent CYP450 3A4 inhibitor such as ketoconazole has been shown to increase galantamine systemic exposure (AUC) by 30%. Erythromycin and cimetidine, which are less potent inhibitors, have been shown to increase galantamine AUC by 10% and 16%, respectively.

MANAGEMENT: Pharmacologic response to galantamine should be monitored more closely whenever a potent CYP450 3A4 inhibitor (e.g., clarithromycin, telithromycin, itraconazole, ketoconazole, posaconazole, voriconazole, conivaptan, nefazodone, cobicistat, delavirdine, protease inhibitors) is added to or withdrawn from therapy, and the galantamine dosage adjusted as necessary. Patients should be advised to notify their physician if they experience excessive cholinergic symptoms such as severe nausea, vomiting, GI cramping, salivation, lacrimation, sweating, dizziness, or syncope.

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