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Drug Interactions between imiglucerase and Zavesca

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

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Interactions between your drugs

Moderate

imiglucerase migLUstat

Applies to: imiglucerase and Zavesca (miglustat)

Ask your doctor before using imiglucerase together with migLUstat. Using these medications together can decrease the effects of imiglucerase. Contact your doctor if your condition worsens. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both 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.

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Drug and food interactions

Moderate

migLUstat food

Applies to: Zavesca (miglustat)

Consumer information for this interaction is not currently available.

ADJUST DOSING INTERVAL: Coadministration of miglustat with food may result in delayed absorption and decreased maximum plasma concentration (Cmax) in patients. In healthy subjects, coadministration of miglustat (100 mg) with food resulted in a decrease in the rate of absorption. The Cmax was decreased by 36% and the time to reach Cmax was delayed by 2 hours. However, the systemic exposure (AUC) was only decreased by 14%, which was not found to be statistically significant.

MONITOR: Administration of miglustat with high carbohydrate containing foods may increase the incidence of diarrhea and associated gastrointestinal complaints. The proposed mechanism is the inhibitory activity of miglustat on intestinal disaccharidases such as sucrase-isomaltase in the gastrointestinal tract, reducing absorption of dietary disaccharides in the small intestine and resulting in osmotic diarrhea. In clinical studies, diarrhea was observed in more than 80% of patients on miglustat therapy.

MANAGEMENT: The manufacturer of the miglustat formulation (brand name Opfolda) indicated for use in combination with cipaglucosidase alfa recommends separating miglustat from food and beverages (except for the unsweetened beverage used to swallow the capsule) by at least 2 hours before and after administration. Examples of unsweetened beverages include water, tea, or coffee with no cream, sugar, or sweeteners. The manufacturers of other miglustat formulations (e.g., brand names Zavesca, Yargesa) advise that they can be given with or without food. However, an individualized modification of the patient's diet (e.g., reduction of sucrose, lactose, and other carbohydrate intake), use of anti-diarrheal medications, taking the medication between meals and/or temporary dosage reduction may be required if diarrhea and/or other gastrointestinal events occur. Further evaluation for an underlying gastrointestinal issue should be considered if these adverse events persist irrespective of intervention. Consult the manufacturer's product labeling for additional information.

References

  1. "Product Information. Pombiliti (cipaglucosidase alfa)." Amicus Therapeutics U.S., Inc. (2023):
  2. "Product Information. Opfolda (migLUstat)." Amicus Therapeutics U.S., Inc. (2023):
  3. "Product Information. Zavesca (migLUstat)." Actelion Pharmaceuticals US Inc (2022):
  4. "Product Information. Opfolda (miglustat)." Amicus Therapeutics UK Operations Ltd (2023):
  5. "Product Information. Miglustat (miglustat)." Flynn Pharma Ltd (2023):
  6. "Product Information. Yargesa (miglustat)." Piramal Critical Care Ltd (2023):
View all 6 references

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Agents for gaucher disease

Therapeutic duplication

The recommended maximum number of medicines in the 'agents for Gaucher disease' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'agents for Gaucher disease' category:

  • imiglucerase
  • Zavesca (miglustat)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

See also

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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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