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Drug Interactions between landiolol and ozanimod

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

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Interactions between your drugs

Moderate

landiolol ozanimod

Applies to: landiolol and ozanimod

Consumer information for this interaction is not currently available.

MONITOR: The risk of transient bradycardia and atrioventricular (AV) block may be increased during initiation of ozanimod treatment in patients receiving other drugs that slow heart rate or AV conduction such as beta-blockers, certain calcium channel blockers (e.g., diltiazem, verapamil), and digitalis. Ozanimod can cause a decrease in heart rate during initiation of therapy. In two studies, following an initial dose of 0.23 mg, the greatest mean decrease from baseline in heart rate of 1.2 bpm occurred at hour 5 on day 1 and returned to near baseline at hour 6. Following continued up-titration, the maximal heart rate effect of ozanimod occurred on day 8. Heart rates below 40 bpm were not observed. Initiation of ozanimod without dose titration may result in greater decreases in heart rate. Initiation of ozanimod treatment has also resulted in transient AV conduction delays. Reportedly, administration of ozanimod at doses higher than the recommended dosage and without dose titration, first- and second-degree AV block occurred in healthy subjects. However, in two studies which utilized dose titration, second- or third-degree AV block was not reported in patients receiving ozanimod.

MANAGEMENT: Ozanimod has not been adequately studied in patients receiving concomitant therapy with drugs that decrease heart rate. Since initiation of ozanimod may result in a transient decrease in heart rate and AV conduction delays, the manufacturer's product labeling should be consulted for an up-titration scheme to reach the maintenance dosage of ozanimod. This may attenuate the magnitude of heart rate reductions. In addition, advice from a cardiologist should be sought if coadministration of ozanimod is considered in patients with significant QT prolongation (QTcF greater than 450 msec in males or 470 msec in females), patients with arrhythmias requiring treatment with Class 1a or Class III antiarrhythmic agents, patients with ischemic heart disease, heart failure, history of cardiac arrest or myocardial infarction, cerebrovascular disease, or uncontrolled hypertension. Use of ozanimod in patients with a history of second-degree Mobitz type II or higher AV block, sick-sinus syndrome, or sinoatrial heart block is considered contraindicated unless the patient has a functioning pacemaker.

Drug and food interactions

Moderate

ozanimod food

Applies to: ozanimod

Ozanimod may be taken with or without food. While there is no need to strictly avoid most foods and beverages that contain tyramine (usually aged, fermented, cured, smoked, or pickled foods such as air-dried and fermented meats or fish, aged cheeses, most soybean products, yeast extracts, red wine, beer, and sauerkraut) during treatment with ozanimod, certain foods such as some of the aged cheeses (for example, Boursault, Liederkrantz, Mycella, and Stilton) and pickled herring may contain very high amounts of tyramine and should generally be avoided if possible. Consumption of very high levels of tyramine (greater than 150 mg) while on ozanimod treatment may lead to dangerous increases in your blood pressure, a condition known as hypertensive crisis. Talk to your doctor or pharmacist if you are uncertain about what foods, if any, to avoid. You should seek immediate medical attention if you experience sudden and severe headache, blurred vision, confusion, seizures, chest pain, nausea or vomiting, sudden numbness or weakness (especially on one side of the body), speech difficulties, fever, sweating, lightheadedness, and/or fainting during treatment with ozanimod, as these may be signs and symptoms of a hypertensive crisis. 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.

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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