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Drug Interactions between eluxadoline and Entresto

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

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Interactions between your drugs

Moderate

valsartan eluxadoline

Applies to: Entresto (sacubitril / valsartan) and eluxadoline

MONITOR: Coadministration with eluxadoline may increase the plasma concentrations of drugs that are substrates of the organic anion transporting polypeptide (OATP) 1B1 and/or breast cancer resistance protein (BCRP) transporters. The mechanism is decreased clearance due to inhibition of OATP1B1-mediated hepatic uptake and BCRP-mediated intestinal and hepatobiliary efflux by eluxadoline. The interaction has been demonstrated for rosuvastatin, a known substrate of both OATP 1B1 and BCRP. When a single 20 mg dose of rosuvastatin was given during multiple dosing of eluxadoline 100 mg twice daily, rosuvastatin peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 18% and 40%, respectively, compared to administration of rosuvastatin alone. Similar results were reported for the active major metabolite, n-desmethyl rosuvastatin.

MANAGEMENT: Caution is advised when eluxadoline is used concomitantly with drugs that are substrates of the OATP1B1 and/or BCRP transporters, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever eluxadoline is added to or withdrawn from therapy.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. "Product Information. Viberzi (eluxadoline)." Actavis Pharma, Inc. (2015):

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Drug and food interactions

Major

eluxadoline food

Applies to: eluxadoline

CONTRAINDICATED: Consumption of more than 3 alcoholic beverages per day may increase the risk of acute pancreatitis during treatment with eluxadoline. Pancreatitis has been reported rarely during clinical trials of eluxadoline, and may or may not be related to sphincter of Oddi spasm.

ADJUST DOSING INTERVAL: High-fat meals may reduce the oral bioavailability of eluxadoline. In 28 healthy volunteers, administration of a single 100 mg dose of eluxadoline with a high-fat meal (approximately 800 to 1000 total calories, 50% from fat) decreased eluxadoline peak plasma concentration (Cmax) and systemic exposure (AUC) by 50% and 60%, respectively, compared to administration in the fasted state. There was no significant effect on the time to peak concentration (Tmax). The clinical relevance of this interaction is unknown. It should be noted that phase 3 clinical trials were conducted under fed conditions.

MANAGEMENT: Chronic or acute excessive use of alcohol should be avoided during treatment with eluxadoline. Alcoholism, alcohol abuse, alcohol addiction, and consumption of more than 3 alcoholic beverages per day are considered contraindications to the use of eluxadoline. The product labeling recommends taking eluxadoline with food. Patients should be advised to stop taking eluxadoline and seek medical attention if they experience potential symptoms of pancreatitis such as persistent nausea, vomiting, abdominal tenderness, and upper abdominal pain, especially that which is made worse after eating or radiates to the back or shoulders.

References

  1. "Product Information. Viberzi (eluxadoline)." Actavis Pharma, Inc. (2015):

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Moderate

valsartan food

Applies to: Entresto (sacubitril / valsartan)

GENERALLY AVOID: Moderate-to-high dietary intake of potassium, especially salt substitutes, may increase the risk of hyperkalemia in some patients who are using angiotensin II receptor blockers (ARBs). ARBs can promote hyperkalemia through inhibition of angiotensin II-induced aldosterone secretion. Patients with diabetes, heart failure, dehydration, or renal insufficiency have a greater risk of developing hyperkalemia.

MANAGEMENT: Patients should receive dietary counseling and be advised to not use potassium-containing salt substitutes or over-the-counter potassium supplements without consulting their physician. If salt substitutes are used concurrently, regular monitoring of serum potassium levels is recommended. Patients should also be advised to seek medical attention if they experience symptoms of hyperkalemia such as weakness, irregular heartbeat, confusion, tingling of the extremities, or feelings of heaviness in the legs.

References

  1. "Product Information. Cozaar (losartan)." Merck & Co., Inc PROD (2001):
  2. "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals PROD (2001):

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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.

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