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Can you take Felbamate with Opicapone?

1 drug interaction and 16 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

felbamate opicapone

Applies to: felbamate and opicapone

Using felbamate together with opicapone may increase side effects such as:

  • dizziness
  • drowsiness
  • confusion
  • difficulty concentrating

Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination.

What to do: You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you.

Talk to your doctor if you have any questions or concerns. 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.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

felbamate Food/Lifestyle

Applies to: felbamate

Alcohol can increase the nervous system side effects of felbamate such as:

  • dizziness
  • drowsiness
  • difficulty concentrating

Some people may also experience impairment in thinking and judgment.

You should avoid or limit the use of alcohol while being treated with felbamate.

Do not use more than the recommended dose of felbamate, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.

Talk to your doctor or pharmacist if you have any questions or concerns.

Moderate:

opicapone Food/Lifestyle

Applies to: opicapone

Food may delay and reduce the absorption of opicapone, which may lead to lower blood levels of the medication and possibly reduced effectiveness.

You should take opicapone once daily at bedtime. Do not eat food for at least 1 hour before and at least 1 hour after taking opicapone.

Talk to your doctor or pharmacist if you have any questions or concerns.

Disease interactions

14 potential interactions Applies to: 11 conditions, including Depression, Hypotension, Anemia, Psychosis, and Lactose Intolerance.

Adrenal Tumor

Major:

opicapone

Opicapone has a major potential interaction with Adrenal Tumor.

The use of opicapone is contraindicated in patients with pheochromocytoma, paraganglioma, or other catecholamine secreting neoplasms.

Anemia

Major:

felbamate

Felbamate has a major potential interaction with Anemia.

The use of felbamate is contraindicated in patients with bone marrow suppression or a current or prior history of blood dyscrasias. A marked increase in the incidence of aplastic anemia has been associated with the use of felbamate, reportedly exceeding 100 times the incidence observed in the general population (2 to 5 per million persons per year). In the few cases that have been reported in felbamate patients, the onset of clinical manifestations of aplastic anemia ranged from 5 to 30 weeks. However, the injury to bone marrow stem cells that is believed to be ultimately responsible for the anemia may occur much earlier. Currently, it is not known whether the risk is related to dose, duration of exposure, and/or concomitant use of other antiepileptic or myelotoxic drugs. Expert hematologic consultation should be available for all patients treated with felbamate. Since aplastic anemia typically develops without premonitory clinical or laboratory signs, it should be borne in mind that routine blood testing may not be reliably used to prevent development of the syndrome. However, in some cases, it may allow the detection of hematologic changes before the condition is full-blown. Felbamate therapy should be withdrawn if evidence of bone marrow depression is observed. Patients who are discontinued from the drug may remain at risk for developing anemia for a variable and unknown period afterwards and should be monitored accordingly.

Bone Marrow Depression/Low Blood Counts

Major:

felbamate

Felbamate has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

The use of felbamate is contraindicated in patients with bone marrow suppression or a current or prior history of blood dyscrasias. A marked increase in the incidence of aplastic anemia has been associated with the use of felbamate, reportedly exceeding 100 times the incidence observed in the general population (2 to 5 per million persons per year). In the few cases that have been reported in felbamate patients, the onset of clinical manifestations of aplastic anemia ranged from 5 to 30 weeks. However, the injury to bone marrow stem cells that is believed to be ultimately responsible for the anemia may occur much earlier. Currently, it is not known whether the risk is related to dose, duration of exposure, and/or concomitant use of other antiepileptic or myelotoxic drugs. Expert hematologic consultation should be available for all patients treated with felbamate. Since aplastic anemia typically develops without premonitory clinical or laboratory signs, it should be borne in mind that routine blood testing may not be reliably used to prevent development of the syndrome. However, in some cases, it may allow the detection of hematologic changes before the condition is full-blown. Felbamate therapy should be withdrawn if evidence of bone marrow depression is observed. Patients who are discontinued from the drug may remain at risk for developing anemia for a variable and unknown period afterwards and should be monitored accordingly.

Depression

Moderate:

felbamate

Felbamate has a moderate potential interaction with Depression.

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.

History of Blood Dyscrasias

Major:

felbamate

Felbamate has a major potential interaction with History of Blood Dyscrasias.

The use of felbamate is contraindicated in patients with bone marrow suppression or a current or prior history of blood dyscrasias. A marked increase in the incidence of aplastic anemia has been associated with the use of felbamate, reportedly exceeding 100 times the incidence observed in the general population (2 to 5 per million persons per year). In the few cases that have been reported in felbamate patients, the onset of clinical manifestations of aplastic anemia ranged from 5 to 30 weeks. However, the injury to bone marrow stem cells that is believed to be ultimately responsible for the anemia may occur much earlier. Currently, it is not known whether the risk is related to dose, duration of exposure, and/or concomitant use of other antiepileptic or myelotoxic drugs. Expert hematologic consultation should be available for all patients treated with felbamate. Since aplastic anemia typically develops without premonitory clinical or laboratory signs, it should be borne in mind that routine blood testing may not be reliably used to prevent development of the syndrome. However, in some cases, it may allow the detection of hematologic changes before the condition is full-blown. Felbamate therapy should be withdrawn if evidence of bone marrow depression is observed. Patients who are discontinued from the drug may remain at risk for developing anemia for a variable and unknown period afterwards and should be monitored accordingly.

Hypotension

Moderate:

opicapone

Opicapone has a moderate potential interaction with Hypotension.

Opicapone may cause orthostatic blood pressure changes including fainting and dizziness and patients should be advised to avoid standing rapidly after sitting or lying down. Caution is advised in patients with hypotension.

Lactose Intolerance

Moderate:

opicapone

Opicapone has a moderate potential interaction with Lactose Intolerance.

Opicapone formulations contain lactose. Caution is advised if used in patients with lactose intolerance.

Liver Disease

Major:

felbamate

Felbamate has a major potential interaction with Liver Disease.

The use of felbamate is contraindicated in patients with a history of hepatic impairment. A marked increase in the incidence of hepatic failure, some resulting in fatality, has been associated with the use of felbamate relative to that expected in the general population (approximately 2000 cases per year). Currently, it is not known whether the risk is related to dose, duration of exposure, and/or concomitant use of other antiepileptic or hepatotoxic drugs. All patients treated with felbamate should have serum transaminase and bilirubin levels checked prior to initiating therapy and at 1- to 2-week intervals while treatment continues. Felbamate therapy should be withdrawn if abnormal liver function tests occur.

Moderate:

opicapone

Opicapone has a moderate potential interaction with Liver Disease.

The mean overall plasma exposure (AUC) of opicapone increased by 84% in patients with moderate (Child-Pugh Class B) liver dysfunction. A dosage adjustment is required on these patients. The pharmacokinetics of this drug have not been studied in patients with severe liver dysfunction (Child-Pugh: C). Caution is advised.

Pheochromocytoma

Major:

opicapone

Opicapone has a major potential interaction with Pheochromocytoma.

The use of opicapone is contraindicated in patients with pheochromocytoma, paraganglioma, or other catecholamine secreting neoplasms.

Psychosis

Major:

opicapone

Opicapone has a major potential interaction with Psychosis.

Opicapone may cause impulse control disorders including pathological gambling, increased libido, hypersexuality, compulsive spending or buying, binge eating, and compulsive eating. Patients with a major psychotic disorder should ordinarily not be treated with this drug because of the risk of exacerbating the psychosis with an increase in central dopaminergic tone.

Moderate:

felbamate

Felbamate has a moderate potential interaction with Psychosis.

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.

Renal Dysfunction

Major:

felbamate

Felbamate has a major potential interaction with Renal Dysfunction.

Felbamate is partially eliminated by the kidney as unchanged drug (approximately 40% to 50% of absorbed dose). The plasma clearance of felbamate may be decreased and the half-life prolonged in patients with impaired renal function. Therapy with felbamate should be administered cautiously in patients with renal impairment.

Moderate:

opicapone

Opicapone has a moderate potential interaction with Renal Dysfunction.

The pharmacokinetics of opicapone have not been studied in patients with end stage renal disease. Caution is advised.

More resources

felbamate

A total of 554 drugs are known to interact with felbamate.

opicapone

A total of 279 drugs are known to interact with opicapone.

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.