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Drug Interactions between ensifentrine and Mifeprex

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

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Interactions between your drugs

Minor

miFEPRIStone ensifentrine

Applies to: Mifeprex (mifepristone) and ensifentrine

Coadministration with inhibitors of CYP450 2C9 may increase the plasma concentrations of ensifentrine. According to the prescribing information, ensifentrine's primary routes of metabolism are oxidative (hydroxylation and O-demethylation) followed by conjugation. Additionally, in vitro data indicates ensifentrine is predominantly metabolized by CYP450 2C9, and to a lesser extent by CYP450 2D6. When ensifentrine (3 mg single dose) was coadministered with the CYP450 2C9 inhibitor fluconazole (200 mg twice daily) to 28 healthy volunteers, ensifentrine systemic exposure (AUC) increased by 1.6-fold and peak plasma concentration (Cmax) increased by 1.4-fold. The increase in ensifentrine exposure by fluconazole was not considered clinically relevant.

References (2)
  1. (2024) "Product Information. Ohtuvayre (ensifentrine)." Verona Pharma
  2. Rheault T, Kankam M, ayrton j, bengtsson t, rickard k (2024) The effect of fluconazole on the pharmacokinetics of ensifentrine in healthy individuals https://erj.ersjournals.com/content/58/suppl_65/PA2137

Drug and food interactions

Moderate

miFEPRIStone food

Applies to: Mifeprex (mifepristone)

ADJUST DOSING INTERVAL: Food may significantly increase the plasma concentrations of mifepristone.

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of mifepristone. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Because pharmacokinetic interactions involving grapefruit juice are often subject to a high degree of interpatient variability, the extent to which a given patient may be affected is difficult to predict.

MANAGEMENT: When mifepristone is used daily to control hyperglycemia secondary to hypercortisolism in patients with endogenous Cushing's syndrome, it should be taken with food to achieve consistent plasma drug levels. Patients should be advised to avoid consuming grapefruit or grapefruit juice during treatment with mifepristone, as it may cause increased adverse effects such as headache, dizziness, fatigue, nausea, vomiting, cramping, diarrhea, hypokalemia, adrenal insufficiency, vaginal bleeding, arthralgia, peripheral edema, and hypertension. Because mifepristone is eliminated slowly from the body, the interaction with grapefruit juice may be observed for a prolonged period.

References (2)
  1. (2001) "Product Information. Mifeprex (mifepristone)." Danco Laboratories
  2. (2012) "Product Information. Korlym (mifepristone)." Corcept Therapeutics Incorporated

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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