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Drug Interactions between cyproheptadine and vilazodone

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

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Interactions between your drugs

Moderate

cyproheptadine vilazodone

Applies to: cyproheptadine and vilazodone

MONITOR: Serotonin antagonists such as cyproheptadine and methysergide may diminish the pharmacologic effects of selective serotonin reuptake inhibitors (SSRIs) and other highly serotonergic agents (e.g., 5-hydroxytryptophan; buspirone; mirtazapine; nefazodone; sibutramine; St. John's wort; trazodone; SNRIs such as duloxetine, desvenlafaxine, milnacipran, and venlafaxine). This pharmacodynamic interaction is sometimes exploited in the use of cyproheptadine and methysergide for the treatment of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Theoretically, serotonergic agents may also antagonize the pharmacologic effects of cyproheptadine and methysergide, although this effect has not been reported.

MANAGEMENT: Patients should be monitored for potentially diminished therapeutic response to serotonergic agents during coadministration with cyproheptadine or methysergide, and dosages adjusted as necessary.

References (10)
  1. Goldbloom DS, Kennedy SH (1991) "Adverse interaction of fluoxetine and cyproheptadine in two patients with bulimia nervosa." J Clin Psychiatry, 52, p. 261-2
  2. Feder R (1991) "Reversal of antidepressant activity of fluoxetine by cyproheptadine in three patients." J Clin Psychiatry, 52, p. 163-4
  3. Nierenberg DW, Semprebon M (1993) "The central nervous system serotonin syndrome." Clin Pharmacol Ther, 53, p. 84-8
  4. Sternbach H (1991) "The serotonin syndrome." Am J Psychiatry, 148, p. 705-13
  5. Katz RJ, Rosenthal M (1994) "Adverse interaction of cyproheptadine with serotonergic antidepressants." J Clin Psychiatry, 55, p. 314-5
  6. Christensen RC (1995) "Adverse interaction of paroxetine and cyproheptadine." J Clin Psychiatry, 56, p. 433-4
  7. Mills KC (1997) "Serotonin syndrome: A clinical update." Crit Care Clin, 13, p. 763
  8. Klepser T, Nisly N (2000) "5-Hydroxytryptophan (5-HTP) for treatment of depression." Alternative Medicine Alert, 3, p. 121-4
  9. Martin TG (1996) "Serotonin syndrome." Ann Emerg Med, 28, p. 520-6
  10. Lane R, Baldwin D (1997) "Selective serotonin reuptake inhibitor--induced serotonin syndrome: review." J Clin Psychopharmacol, 17, p. 208-21

Drug and food interactions

Moderate

cyproheptadine food

Applies to: cyproheptadine

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

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References (4)
  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
Moderate

vilazodone food

Applies to: vilazodone

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

ADJUST DOSING INTERVAL: Food enhances the oral bioavailability of vilazodone. According to the product labeling, vilazodone blood concentrations in the fasted state can be decreased by approximately 50% compared to the fed state, which may result in diminished effectiveness in some patients. The absolute bioavailability of vilazodone is 72% with food. In study subjects, administration with food (high-fat or light meal) increased vilazodone peak plasma concentration (Cmax) by approximately 147% to 160% and systemic exposure (AUC) by approximately 64% to 85%.

MANAGEMENT: Patients receiving vilazodone should be advised to avoid consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how vilazodone affects them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities. Vilazodone should be taken with food. Administration without food may result in inadequate drug concentrations and diminished effectiveness.

References (1)
  1. (2011) "Product Information. Viibryd (vilazodone)." Trovis Pharmaceuticals LLC

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

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