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Drug Interactions between lamivudine / raltegravir and Mysoline

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

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Interactions between your drugs

Minor

primidone raltegravir

Applies to: Mysoline (primidone) and lamivudine / raltegravir

Coadministration with inducers of uridine diphosphate glucuronosyltransferase (UGT) 1A1 may reduce the plasma concentrations of raltegravir, which is primarily metabolized by UGT1A1-mediated glucuronidation. In 9 study subjects, administration of a single 400 mg dose of raltegravir in combination with the potent UGT1A1 inducer rifampin (600 mg daily) resulted in a 38% decrease in raltegravir peak plasma concentration (Cmax), a 40% decrease in systemic exposure (AUC), and a 61% decrease in trough plasma concentration (Cmin) compared to administration of raltegravir alone. The impact of other potent inducers of drug-metabolizing enzymes such as carbamazepine, phenytoin, and phenobarbital on UGT1A1 is unknown. Other, less potent inducers (e.g., efavirenz, nevirapine, etravirine, rifabutin, dexamethasone, St. John's Wort, pioglitazone) may be used with the recommended dosage of raltegravir.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Canadian Pharmacists Association "e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink" (2006):
  3. "Product Information. Isentress (raltegravir)." Merck & Co., Inc (2007):
  4. Cerner Multum, Inc. "Australian Product Information." O 0
View all 4 references

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Drug and food interactions

Major

primidone food

Applies to: Mysoline (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

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

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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.

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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