Drug Interactions between Librax and teduglutide

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

MONITOR: Teduglutide has the potential to increase absorption of concomitantly administered oral medications. Altered mental status in association with teduglutide treatment has been observed in patients on benzodiazepines in clinical trials. In one case, a patient who received prazepam with teduglutide 0.05 mg/kg/day experienced dramatic deterioration in mental status progressing to coma during her first week of teduglutide therapy. She was admitted to the intensive care unit, where her benzodiazepine level was found to exceed 300 mcg/L. Both medications were discontinued, and the coma resolved five days later.

MANAGEMENT: Careful monitoring and possible dosage adjustment of oral medications that require titration or have a narrow therapeutic index are recommended during coadministration with teduglutide.

GENERALLY AVOID: Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous. In addition, the potential for abuse may be increased with the combination. The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system. No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load. However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.

MANAGEMENT: Alcohol should generally be avoided during therapy with anticholinergic agents. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.