Drug Interactions between Detrol and lefamulin

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Lefamulin may cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result in additive effects and increased risk of ventricular arrhythmias including torsade de pointes and sudden death. In two randomized, double-blind, double-dummy, active-controlled (moxifloxacin 400 mg once daily) studies, a concentration-dependent QTc prolongation effect of lefamulin was observed. The mean change from baseline QTcF around Tmax on day 3 or 4 was 13.6 msec for lefamulin 150 mg administered twice daily by infusion and 9.3 msec for lefamulin 600 mg administered twice daily orally, compared to 16.4 msec for moxifloxacin 400 mg administered once daily by infusion and 11.6 msec for moxifloxacin 400 mg administered once daily orally. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). In addition, the extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drug(s).

MANAGEMENT: Coadministration of lefamulin with other drugs that can prolong the QT interval should generally be avoided. Caution and clinical monitoring are recommended if concomitant use is required. Patients should have electrocardiograms (ECGs) and electrolyte levels assessed during treatment as appropriate based on individual risk factors. The recommended dosage and infusion rate of lefamulin should not be exceeded, as the magnitude of QT prolongation may increase with increasing concentrations of the drug or increasing the rate of infusion. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope.