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Drug Interactions between ixabepilone and primidone

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

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Interactions between your drugs

Major

primidone ixabepilone

Applies to: primidone and ixabepilone

GENERALLY AVOID: Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of ixabepilone, which is primarily metabolized by the isoenzyme. According to the manufacturer, coadministration of ixabepilone with the potent CYP450 3A4 inducer rifampin decreased ixabepilone systemic exposure (AUC) by 43% compared to administration of ixabepilone alone. Reduced efficacy of ixabepilone may occur.

MANAGEMENT: The use of ixabepilone in combination with potent CYP450 3A4 inducers should generally be avoided. If coadministration is required, the manufacturer recommends increasing the ixabepilone dosage from 40 mg/m2 to 60 mg/m2 as tolerated. Following discontinuation of the potent CYP450 3A4 inducer, the dosage of ixabepilone should be returned to that used prior to initiation of the inducer.

References (1)
  1. (2023) "Product Information. Ixempra (ixabepilone)." R-Pharm US LLC

Drug and food interactions

Major

primidone food

Applies to: primidone

GENERALLY AVOID: Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.

MANAGEMENT: The combination of ethanol and barbiturates should be avoided.

References (5)
  1. Gupta RC, Kofoed J (1966) "Toxological statistics for barbiturates, other sedatives, and tranquilizers in Ontario: a 10-year survey." Can Med Assoc J, 94, p. 863-5
  2. Misra PS, Lefevre A, Ishii H, Rubin E, Lieber CS (1971) "Increase of ethanol, meprobamate and pentobarbital metabolism after chronic ethanol administration in man and in rats." Am J Med, 51, p. 346-51
  3. Saario I, Linnoila M (1976) "Effect of subacute treatment with hypnotics, alone or in combination with alcohol, on psychomotor skills related to driving." Acta Pharmacol Toxicol (Copenh), 38, p. 382-92
  4. Stead AH, Moffat AC (1983) "Quantification of the interaction between barbiturates and alcohol and interpretation of fatal blood concentrations." Hum Toxicol, 2, p. 5-14
  5. Seixas FA (1979) "Drug/alcohol interactions: avert potential dangers." Geriatrics, 34, p. 89-102
Moderate

ixabepilone food

Applies to: ixabepilone

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of ixabepilone. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits.

MANAGEMENT: Patients treated with ixabepilone should avoid the consumption of grapefruit or grapefruit juice.

References (1)
  1. (2007) "Product Information. Ixempra (ixabepilone)." Bristol-Myers Squibb

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.

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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