Drug Interactions between lorcaserin and ranolazine

GENERALLY AVOID: Grapefruit and grapefruit juice may significantly increase the plasma concentrations of orally administered ranolazine. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Because ranolazine prolongs QT interval in a dose-dependent manner, high plasma levels of ranolazine may increase the risk of ventricular arrhythmias such as ventricular tachycardia, ventricular fibrillation, and torsade de pointes.

MANAGEMENT: Patients treated with ranolazine should avoid consumption of grapefruit juice and other grapefruit products if possible. Otherwise, the dosage of ranolazine should be limited to 500 mg twice a day.

Food does not appear to significantly affect the absorption and oral bioavailability of lurasidone. In twelve adult volunteers (6 men and 6 women), administration of a single 10 mg oral dose of lorcaserin following a high-fat (approximately 50% of total caloric content of the meal) and high-calorie (approximately 800 to 1000 calories) meal resulted in less than 10% increases in lorcaserin peak plasma concentration (Cmax) and systemic exposure (AUC) compared to administration in the fasted state. The time to reach peak concentration (Tmax) was delayed by approximately 1 hour in the fed state. Lorcaserin may be administered with or without food.