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Drug Interactions between Kynmobi and vericiguat

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

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Interactions between your drugs

Major

apomorphine vericiguat

Applies to: Kynmobi (apomorphine) and vericiguat

MONITOR CLOSELY: Apomorphine may potentiate the hypotensive effects of vasodilators, antihypertensive agents, or agents with hypotensive properties. Apomorphine alone has been associated with orthostatic hypotension, hypotension, syncope, and dose-dependent decreases in systolic and diastolic blood pressure. In clinical studies of the subcutaneous formulation of apomorphine in patients with advanced Parkinson's disease, hypotension (10% vs 4%), myocardial infarction (3% vs. 1%), serious pneumonia (5% vs. 3%), serious falls (9% vs. 3%), and bone and joint injuries (6% vs. 2%) were experienced more commonly in patients receiving concomitant antihypertensive medications or vasodilators (n=94) compared to those not receiving these medications (n=456). Some of these events may be related to the increased incidence of hypotension.

MANAGEMENT: Caution and close monitoring for altered efficacy and safety are recommended if patients receive apomorphine with an antihypertensive agent, vasodilator, or agents with hypotensive properties. Patients should be made aware of the possible side effects (e.g., dizziness, lightheadedness, orthostasis) and be cautioned about driving, operating machinery, or performing other hazardous tasks. They should also be advised to avoid rising abruptly from a sitting or recumbent position and to contact their physician if they experience symptoms of hypotension such as dizziness, lightheadedness, or fainting.

References (5)
  1. (2022) "Product Information. Apokyn (apomorphine)." US WorldMeds LLC
  2. (2022) "Product Information. Kynmobi (apomorphine)." Sunovion Pharmaceuticals Inc
  3. (2023) "Product Information. Dacepton (apomorphine)." Ever Pharma UK Ltd
  4. (2024) "Product Information. aPomine Intermittent (apomorphine)." Pfizer Australia Pty Ltd, 1.1
  5. (2024) "Product Information. Movapo (apomorphine)." Stada Pharmaceuticals Australia Pty Ltd

Drug and food interactions

Moderate

apomorphine food

Applies to: Kynmobi (apomorphine)

GENERALLY AVOID: Alcohol and apomorphine may have additive hypotensive and sedative effects. Coadministration of 0.6 or 0.3 g/kg of ethanol with apomorphine in healthy subjects resulted in greater decreases in blood pressure compared to apomorphine alone. The mean largest decrease (the mean of each subject's largest drop in blood pressure measured within 6 hours after apomorphine administration) in standing systolic and diastolic blood pressure was 6.7 and 8.4 mmHg, respectively, with apomorphine alone. When coadministered with 0.6 g/kg of ethanol (equivalent to approximately 3 standardized alcohol-containing beverages), the mean largest decrease in standing systolic and diastolic blood pressure was 11.3 and 12.6 mmHg, respectively (standing systolic and diastolic blood pressure decreased by as much as 61 and 51 mmHg, respectively, in this group). When coadministered with 0.3 g/kg of ethanol, the mean largest decrease in standing systolic and diastolic blood pressure was 8.4 and 7.1 mmHg, respectively.

MANAGEMENT: Patients should be advised to avoid consumption of alcohol during apomorphine treatment.

References (5)
  1. (2022) "Product Information. Apokyn (apomorphine)." US WorldMeds LLC
  2. (2022) "Product Information. Kynmobi (apomorphine)." Sunovion Pharmaceuticals Inc
  3. (2023) "Product Information. Dacepton (apomorphine)." Ever Pharma UK Ltd
  4. (2024) "Product Information. aPomine Intermittent (apomorphine)." Pfizer Australia Pty Ltd, 1.1
  5. (2024) "Product Information. Movapo (apomorphine)." Stada Pharmaceuticals Australia Pty Ltd
Moderate

vericiguat food

Applies to: vericiguat

ADJUST DOSING INTERVAL: Administration of vericiguat with food reduces its pharmacokinetic variability and increases its exposure. Vericiguat is less soluble at neutral pH than at acidic pH. Administration of vericiguat with a high-fat, high-calorie meal or low-fat, high-carbohydrate meal increased time to reach peak plasma concentration (Tmax) from about 1 hour (fasted) to about 4 hours (fed) and increased vericiguat systemic exposure (AUC) by 19% and peak plasma concentration (Cmax) by 9% for the 5 mg tablet and by 44% (AUC) and 41% (Cmax) for the 10 mg tablet as compared with the fasted state. Concurrent treatment with drugs that increase gastric pH, such as proton pump inhibitors or antacids, decrease vericiguat AUC by about 30%. Co-treatment with drugs that increase gastric pH did not affect vericiguat exposure in patients with heart failure when vericiguat was taken as directed with food.

MANAGEMENT: Administer vericiguat with food to ensure maximal exposure and decrease pharmacokinetic variability.

References (2)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. (2021) "Product Information. Verquvo (vericiguat)." Merck & Co., Inc

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

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