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Drug Interactions between maribavir and phenobarbital

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

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Interactions between your drugs

Major

PHENobarbital maribavir

Applies to: phenobarbital and maribavir

ADJUST DOSE: Coadministration with potent inducers of CYP450 3A4 such as phenobarbital may significantly decrease the plasma concentrations of maribavir, which is primarily metabolized by the isoenzyme. According to physiologically-based pharmacokinetic modeling, maribavir peak plasma concentration (Cmax) and systemic exposure (AUC) were 2.2- and 1.8-fold higher, respectively, when dose-adjusted maribavir (1200 mg twice daily) was administered with phenobarbital (100 mg once daily) compared to standard-dose maribavir (400 mg twice daily) alone. Studies evaluating the effect of concomitant use of phenobarbital with standard-dose maribavir are not available. However, when standard-dose maribavir was administered with another potent CYP450 3A4 inducer, rifampin (600 mg once daily), maribavir peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 39% and 60%, respectively. Reduced virologic response may occur.

MANAGEMENT: If concomitant use of phenobarbital is required, the manufacturer recommends that the dosage of maribavir should be increased to 1200 mg twice daily.

References (1)
  1. (2021) "Product Information. Livtencity (maribavir)." Takeda Pharmaceuticals America

Drug and food interactions

Major

PHENobarbital food

Applies to: phenobarbital

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

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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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