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Drug Interactions between Hetlioz LQ and thiabendazole

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

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Interactions between your drugs

Moderate

thiabendazole tasimelteon

Applies to: thiabendazole and Hetlioz LQ (tasimelteon)

MONITOR: Coadministration with inhibitors of CYP450 1A2 and/or 3A4 may increase the plasma concentrations of tasimelteon, which is primarily metabolized by these isoenzymes. When tasimelteon was administered after 6 days of treatment with the potent CYP450 1A2 inhibitor fluvoxamine 50 mg/day, tasimelteon peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 2- and 7-fold, respectively, compared to tasimelteon administered alone. When administered after 5 days of treatment with the potent CYP450 3A4 inhibitor ketoconazole 400 mg/day, tasimelteon AUC increased by approximately 50%.

MANAGEMENT: Caution is advised if tasimelteon is prescribed in combination with inhibitors of CYP450 1A2 and/or 3A4. Patients should be monitored for excessive sedation and other side effects.

References

  1. (2014) "Product Information. Hetlioz (tasimelteon)." Vanda Pharmaceuticals Inc

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Drug and food interactions

Moderate

tasimelteon food

Applies to: Hetlioz LQ (tasimelteon)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of tasimelteon. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

ADJUST DOSING INTERVAL: Food may delay the absorption and onset of action of tasimelteon. According to the product labeling, administration of tasimelteon with a high-fat meal decreased peak plasma concentration (Cmax) by 44% and delayed the median time to reach Cmax by approximately 1.75 hours compared to administration in the fasted state.

MONITOR: Smoking induces CYP450 1A2 and may reduce the plasma concentrations of tasimelteon, which is metabolized by the isoenzyme. According to the product labeling, tasimelteon systemic exposure was approximately 40% lower in smokers than in nonsmokers.

MANAGEMENT: Patients receiving tasimelteon should be advised to avoid or limit consumption of alcohol. Tasimelteon should be taken without food. Patients who smoke may have a reduced therapeutic response to tasimelteon.

References

  1. (2014) "Product Information. Hetlioz (tasimelteon)." Vanda Pharmaceuticals Inc

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Moderate

thiabendazole food

Applies to: thiabendazole

MONITOR: Coadministration with thiabendazole may increase the plasma concentrations of caffeine. The mechanism is thiabendazole inhibition of the CYP450 1A2 metabolism of caffeine. In ten healthy, nonsmoking volunteers, administration of a single 136.5 mg dose of caffeine in combination with a single 500 mg dose of thiabendazole resulted in a nearly 60% increase in the area under the plasma concentration-time curve (AUC) of caffeine compared to administration without thiabendazole. In addition, the half-life of caffeine was increased from 11.9 to 28.6 hours, and oral clearance was reduced by 67% during coadministration with thiabendazole. The formation of paraxanthine from caffeine, which is primarily mediated by CYP450 1A2, was almost completely abolished until after the thiabendazole was cleared from the system.

MANAGEMENT: Patients should be advised that pharmacologic effects of caffeine may be increased during coadministration with thiabendazole.

References

  1. Bapiro TE, Sayi J, Hasler JA, et al. (2005) "Artemisinin and thiabendazole are potent inhibitors of cytochrome P450 1A2 (CYP1A2) activity in humans." Eur J Clin Pharmacol, 61, p. 755-61

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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.

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