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Drug Interactions between Dormin and Farydak

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

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Interactions between your drugs

Moderate

diphenhydrAMINE panobinostat

Applies to: Dormin (diphenhydramine) and Farydak (panobinostat)

GENERALLY AVOID: Coadministration with panobinostat may increase the plasma concentrations of drugs that are substrates of CYP450 2D6. The mechanism is decreased clearance due to inhibition of CYP450 2D6 activity by panobinostat. When a single 60 mg dose of dextromethorphan, a CYP450 2D6 probe substrate, was coadministered with panobinostat (20 mg once per day on days 3, 5, and 8) in 14 patients with advanced cancer, dextromethorphan peak plasma concentration (Cmax) increased by 20% to 200% (median 80%) and systemic exposure (AUC) increased by 20% to 130% (median 60%) compared to administration of dextromethorphan alone.

MANAGEMENT: Given the high interpatient variability with respect to magnitude of interaction, concomitant use of panobinostat with sensitive CYP450 2D6 substrates (e.g., atomoxetine, desipramine, dextromethorphan, metoprolol, nebivolol, perphenazine, tolterodine, venlafaxine) or CYP450 2D6 substrates that have a narrow therapeutic index (e.g., pimozide, thioridazine) should generally be avoided. Caution is advised when panobinostat is used with other drugs that are metabolized by CYP450 2D6.

References

  1. "Product Information. Farydak (panobinostat)." Novartis Pharmaceuticals (2015):

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Drug and food interactions

Moderate

panobinostat food

Applies to: Farydak (panobinostat)

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of panobinostat. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Increased exposure to panobinostat may increase the risk of adverse effects such as nausea, vomiting, diarrhea, anorexia, peripheral edema, cardiotoxicity, ECG abnormalities, electrolyte disturbances, bleeding complications, hepatotoxicity, and myelosuppression.

Food may delay the rate of absorption of panobinostat, but does not significantly affect the overall extent of absorption. When a single oral dose of panobinostat was administered to 36 patients with advanced cancer 30 minutes after a high-fat meal, panobinostat peak plasma concentration (Cmax) and systemic exposure (AUC) were approximately 44% and 16% lower, respectively, compared to administration under fasting conditions. The median time to maximum concentration (Tmax) was prolonged by 2.5 hours.

MANAGEMENT: Patients should avoid consumption of grapefruit or grapefruit juice during treatment with panobinostat. The manufacturer also recommends avoiding star fruit, Seville oranges, pomegranate, and pomegranate juice. Panobinostat may be administered with or without food.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Cerner Multum, Inc. "Australian Product Information." O 0
  3. "Product Information. Farydak (panobinostat)." Novartis Pharmaceuticals (2015):

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Moderate

diphenhydrAMINE food

Applies to: Dormin (diphenhydramine)

GENERALLY AVOID: Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous. In addition, the potential for abuse may be increased with the combination. The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system. No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load. However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.

MANAGEMENT: Alcohol should generally be avoided during therapy with anticholinergic agents. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.

References

  1. Linnoila M "Drug effects on psychomotor skills related to driving: interaction of atropine, glycopyrrhonium and alcohol." Eur J Clin Pharmacol 6 (1973): 107-12

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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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