Drug Interactions between IBgard and perampanel

The following applies to enteric-coated, gastro-resistant formulations of peppermint oil (usually delayed or sustained release capsules):

Administration with food may disrupt the release mechanism of delayed or extended release formulations of peppermint oil by causing premature dissolution of the enteric coating in the stomach, resulting in early release of the peppermint oil. This can lead to gastrointestinal irritation such as heartburn, indigestion, nausea and vomiting, as well as reduced effectiveness of the medication. Enteric-coated, gastro-resistant formulations of peppermint oil should not be taken immediately after eating. These products should preferably be taken 30 to 90 minutes before a meal with water. The labeling for the specific product should be consulted for administration recommendations and other guidance. Talk to your doctor or pharmacist if you have questions on how to take peppermint oil or any of your other medications. 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.

Alcohol can increase the nervous system side effects of perampanel such as dizziness, drowsiness, and 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 perampanel. Do not use more than the recommended dose of perampanel, 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.