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Drug Interactions between Epidiolex and fezolinetant

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

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Interactions between your drugs

Major

cannabidiol fezolinetant

Applies to: Epidiolex (cannabidiol) and fezolinetant

CONTRAINDICATED: Coadministration with inhibitors of CYP450 1A2 may significantly increase the plasma concentrations of fezolinetant, which is primarily metabolized by the isoenzyme. In clinical drug interaction studies, fezolinetant was coadministered with fluvoxamine, mexiletine, and cimetidine (potent, moderate, and weak CYP450 1A2 inhibitors, respectively). Fezolinetant peak plasma concentration (Cmax) increased by 80%, 40%, and 30%, respectively, while its systemic exposure (AUC) increased by 840%, 360%, and 100%, respectively.

MANAGEMENT: Concomitant use of fezolinetant with CYP450 1A2 inhibitors is considered contraindicated.

References

  1. (2023) "Product Information. Veozah (fezolinetant)." Astellas Pharma US, Inc

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Drug and food interactions

Major

fezolinetant food

Applies to: fezolinetant

CONTRAINDICATED: Coadministration with inhibitors of CYP450 1A2 such as caffeine may significantly increase the plasma concentrations of fezolinetant, which is primarily metabolized by the isoenzyme. The interaction has not been studied with caffeine but has been reported for other CYP450 1A2 inhibitors. Consumption of caffeine-containing food or beverages (e.g., chocolate, coffee, cola drinks, energy drinks, tea) could result in an interaction with fezolinetant. In clinical drug interaction studies, fezolinetant was coadministered with fluvoxamine, mexiletine, and cimetidine (potent, moderate, and weak CYP450 1A2 inhibitors, respectively). Fezolinetant peak plasma concentration (Cmax) increased by 80%, 40%, and 30%, respectively, while its systemic exposure (AUC) increased by 840%, 360%, and 100%, respectively.

MANAGEMENT: Concomitant use of fezolinetant with CYP450 1A2 inhibitors such as caffeine, including caffeine-containing food or beverages, is considered contraindicated.

References

  1. (2023) "Product Information. Veozah (fezolinetant)." Astellas Pharma US, Inc

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Moderate

cannabidiol food

Applies to: Epidiolex (cannabidiol)

ADJUST DOSING INTERVAL: Food may affect the plasma concentrations of cannabidiol. In healthy volunteers, administration of cannabidiol with a high-fat/high-calorie meal increased cannabidiol peak plasma concentration (Cmax) by 5-fold and systemic exposure (AUC) by 4-fold and reduced the total variability compared with administration in the fasted state.

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of cannabidiol. The proposed mechanism is inhibition of CYP450 3A4-mediated metabolism of cannabidiol by certain compounds present in grapefruit. The interaction has not been studied, but the product labeling for cannabidiol recommends consideration of a dosage reduction when used with strong or moderate inhibitors of CYP450 3A4. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition.

MANAGEMENT: Cannabidiol should be taken about the same time each day consistently either with or without food. Patients should limit the consumption of grapefruit and grapefruit juice. If they are coadministered, cannabidiol levels should be monitored and the dosage adjusted as necessary.

References

  1. (2018) "Product Information. Epidiolex (cannabidiol)." Greenwich Biosciences LLC

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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.