Drug Interactions between levomethadyl acetate and telaprevir
This report displays the potential drug interactions for the following 2 drugs:
- levomethadyl acetate
- telaprevir
Interactions between your drugs
levomethadyl acetate telaprevir
Applies to: levomethadyl acetate and telaprevir
CONTRAINDICATED: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations and duration of action of levomethadyl acetate, which is a substrate of the isoenzyme. High plasma levels of levomethadyl acetate may increase the risk of QT interval prolongation, which is thought to be associated with serious cardiac events such as ventricular arrhythmias (e.g., torsade de pointes, ventricular tachycardia), cardiac arrest, and sudden death. Cases of QT prolongation and torsade de pointes have been reported with levomethadyl acetate alone during postmarketing use.
MANAGEMENT: Concomitant use of levomethadyl acetate with CYP450 3A4 inhibitors is considered contraindicated.
References
- (2001) "Product Information. Orlaam (levomethadyl acetate)." Roxane Laboratories Inc
Drug and food interactions
levomethadyl acetate food
Applies to: levomethadyl acetate
GENERALLY AVOID: The concurrent use of levomethadyl acetate and alcohol may result in additive CNS and respiratory depression, hypotension, sedation, or coma. Grapefruit juice may increase the plasma concentrations of orally administered drugs which are substrates of the CYP450 3A4 isoenzyme, such as levomethadyl acetate. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. The extent and clinical significance are unknown. Moreover, pharmacokinetic alterations associated with interactions involving grapefruit juice are often subject to a high degree of interpatient variability.
MANAGEMENT: Patients who are known to abuse alcohol should be warned of the risk of potentially fatal overdose if these substances are taken concurrently. Patients who regularly consume grapefruits and grapefruit juice should be monitored for adverse effects and altered plasma concentrations of levomethadyl acetate. A 12-lead ECG should be performed before initiating therapy, 12 to 14 days after initiating therapy, and periodically thereafter. Patients should be advised to immediately seek medical attention if they experience palpitations, dizziness, lightheadedness, fainting, or seizures. Grapefruits and grapefruit juice should be avoided if an interaction is suspected. Orange juice is not expected to interact.
References
- (2001) "Product Information. Orlaam (levomethadyl acetate)." Roxane Laboratories Inc
telaprevir food
Applies to: telaprevir
ADJUST DOSING INTERVAL: Food significantly enhances the oral bioavailability of telaprevir. When given with a meal containing 533 kcal and 21 g fat, telaprevir systemic exposure (AUC) increased by 237% compared to administration under fasting conditions. The type of meal also affects the exposure to telaprevir. Relative to fasting, telaprevir AUC increased by approximately 117% with a low-fat meal (249 kcal; 3.6 g fat) and 330% with a high-fat meal (928 kcal; 56 g fat). In Phase 3 clinical trials, telaprevir doses were administered within 30 minutes of completing a meal or snack containing approximately 20 grams of fat.
MANAGEMENT: Telaprevir should be administered with food containing approximately 20 grams of fat. Patients should be advised that the fat content of the meal or snack is critical to the absorption of telaprevir. Food taken with telaprevir should be ingested within 30 minutes prior to each dose. Examples of some foods that could be taken with telaprevir include: bagel with cream cheese; half cup of nuts; 3 tablespoons of peanut butter; 1 cup of ice cream; 2 ounces of American or cheddar cheese; 2 ounces of potato chips; or half cup of trail mix.
References
- (2011) "Product Information. Incivek (telaprevir)." Vertex Pharmaceuticals
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
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
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