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Drug Interactions between eplerenone and suvorexant

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

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Interactions between your drugs

Moderate

eplerenone suvorexant

Applies to: eplerenone and suvorexant

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with weak inhibitors of CYP450 3A4 may increase the plasma concentrations of eplerenone, which is primarily metabolized by the isoenzyme. In pharmacokinetic studies, administration of a single 100 mg dose of eplerenone in combination with the potent CYP450 3A4 inhibitor ketoconazole (200 mg twice a day) resulted in a 1.7-fold increase in eplerenone peak plasma concentration (Cmax) and a 5.4-fold increase in systemic exposure (AUC), while administration with moderate inhibitors (erythromycin 500 mg twice daily; verapamil 240 mg once daily; saquinavir 1200 mg three times daily; fluconazole 200 mg once daily) resulted in increases in eplerenone Cmax ranging from 1.4- to 1.6-fold and AUC from 2.0- to 2.9-fold. No data are available for other, less potent inhibitors.

MANAGEMENT: Caution and monitoring are recommended when eplerenone is used with weak CYP450 3A4 inhibitors. Some authorities recommend against the concomitant use of eplerenone with weak CYP450 3A4 inhibitors in patients with an eGFR of 30 to 49 mL/min/1.73m2, and not to exceed 25 mg daily if coadministration is required in patients with an eGFR higher than 50 mL/min /1.73m2.

Drug and food interactions

Moderate

eplerenone food

Applies to: eplerenone

Consumption of grapefruit, grapefruit juice, and supplements that contain grapefruit should be avoided during treatment with eplerenone as they may increase the blood levels and effects of eplerenone. High blood levels of eplerenone can increase the risk of side effects including hyperkalemia (high blood potassium), which in severe cases can lead to kidney failure, muscle paralysis, irregular heart rhythm, and cardiac arrest. You may be more likely to develop hyperkalemia during treatment with eplerenone if you are elderly, dehydrated, or have kidney disease, diabetes, or advanced heart failure. You should seek medical attention if you experience nausea, vomiting, weakness, confusion, tingling of the hands and feet, feelings of heaviness in the legs, a weak pulse, or a slow or irregular heartbeat, as these may be symptoms of hyperkalemia. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate

suvorexant food

Applies to: suvorexant

Food can delay the absorption of suvorexant, which may increase the amount of time it takes for the medication to work. For faster sleep onset, do not take suvorexant with or soon after a meal. Suvorexant should also not be taken with grapefruit juice, as it may significantly increase the levels of medication in the blood. This can increase the risk of side effects including excessive drowsiness, motor impairment, amnesia, anxiety, hallucinations, and breathing difficulties (especially if you have a respiratory disorder such as asthma or obstructive sleep apnea). Talk to your doctor if you have any questions or concerns. You should avoid the use of alcohol while being treated with suvorexant. Avoid driving or operating hazardous machinery until you know how the medication affects you, and do not exceed the dosage or frequency of use prescribed by your doctor. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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.