Can you take Felbamate with Repaglinide?

Repaglinide has a major potential interaction with Adrenal Insufficiency.

The use of insulin is contraindicated during episodes of hypoglycemia. Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.

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 Felbamate therapy should be withdrawn if evidence of bone marrow depression is observed.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.

Repaglinide has a major potential interaction with Anorexia/Feeding Problems.

The use of insulin is contraindicated during episodes of hypoglycemia. Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.

Repaglinide has a major potential interaction with Autonomic Neuropathy.

The use of insulin is contraindicated during episodes of hypoglycemia. Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.

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.

Repaglinide has a major potential interaction with Cardiovascular Conditions and Disorders.

The use of oral hypoglycemic agents may be associated with an increased risk of cardiovascular mortality compared to treatment with diet alone or diet with insulin. This warning is based on the University Group Diabetes Program (UGDP) study, a long-term prospective clinical trial designed to evaluate the effectiveness of glucose-lowering drugs in preventing or delaying vascular complications in patients with non-insulin-dependent diabetes. Patients treated with diet plus a fixed dosage of either tolbutamide (a sulfonylurea) or phenformin (a biguanide) for 5 to 8 years had a cardiovascular mortality rate approximately 2.5 times that of patients treated with diet alone, resulting in discontinuation of both these treatments in the study. Despite controversy regarding interpretation of these results, clinicians and patients should be aware of the potential risk when making treatment decisions for diabetes, particularly in the presence of underlying cardiovascular disease. Data are not available for other sulfonylureas or biguanides, nor for hypoglycemic agents belonging to other classes. However, given the similarities in chemical structure and/or mode of action, the same caution should be applied.

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.

Repaglinide has a major potential interaction with Diabetes, Type 1.

The use of meglitinides is contraindicated in patients with type I diabetes or for the treatment of diabetic ketoacidosis, with or without coma.

Repaglinide has a moderate potential interaction with Diabetes Mellitus.

Patients with severely reduced renal function treated with repaglinide had elevated plasma drug concentrations. Patients with type 2 diabetes who have severe renal function impairment should initiate repaglinide therapy with the 0.5 mg dose and subsequently, patients should be carefully titrated.

Repaglinide has a major potential interaction with Diabetic Ketoacidosis.

The use of meglitinides is contraindicated in patients with type I diabetes or for the treatment of diabetic ketoacidosis, with or without coma.

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.

Repaglinide has a major potential interaction with Hypoglycemia.

The use of insulin is contraindicated during episodes of hypoglycemia. Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.

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.

Repaglinide has a moderate potential interaction with Liver Disease.

Repaglinide is almost completely metabolized in the liver to pharmacologically inactive substances. Patients with impaired liver function may be exposed to higher concentrations of repaglinide and its associated metabolites. Higher serum drug levels, in addition to diminished gluconeogenic capacity secondary to hepatic insufficiency, may increase the potential for severe hypoglycemic episodes. Therapy with repaglinide should be administered cautiously in patients with liver disease. Longer intervals between dosage adjustments may be required.

Repaglinide has a major potential interaction with Malnourishment.

The use of insulin is contraindicated during episodes of hypoglycemia. Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.

Repaglinide has a major potential interaction with Panhypopituitarism.

The use of insulin is contraindicated during episodes of hypoglycemia. Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.

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.

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.

Repaglinide has a moderate potential interaction with Renal Dysfunction.

Patients with severely reduced renal function treated with repaglinide had elevated plasma drug concentrations. Patients with type 2 diabetes who have severe renal function impairment should initiate repaglinide therapy with the 0.5 mg dose and subsequently, patients should be carefully titrated.