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Drug Interactions between metoclopramide and mirabegron

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

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Interactions between your drugs

Moderate

metoclopramide mirabegron

Applies to: metoclopramide and mirabegron

MONITOR: Coadministration with mirabegron may increase the plasma concentrations of drugs that are primarily metabolized by CYP450 2D6. The mechanism is decreased clearance due to inhibition of CYP450 2D6 activity by mirabegron. In 12 healthy male volunteers, administration of a single 100 mg oral dose of metoprolol following pretreatment with immediate-release mirabegron 160 mg orally once daily for 5 days increased the metoprolol peak plasma concentration (Cmax) by 90% and systemic exposure (AUC) by 229% compared to administration of metoprolol alone. Likewise, in 28 healthy male and female volunteers, Cmax of desipramine increased by 79% and AUC increased by 241% when a single 50 mg oral dose of desipramine was administered after multiple-dose administration of extended-release mirabegron 100 mg once daily for 18 days.

MANAGEMENT: Caution is advised if mirabegron must be used concomitantly with medications that undergo metabolism by CYP450 2D6, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever mirabegron is added to or withdrawn from therapy.

References (1)
  1. (2012) "Product Information. Myrbetriq (mirabegron)." Astellas Pharma US, Inc

Drug and food interactions

Moderate

metoclopramide food

Applies to: metoclopramide

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.

References (4)
  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
Minor

mirabegron food

Applies to: mirabegron

Food reduces the oral absorption and bioavailability of mirabegron. According to the product labeling, administration of a 50 mg tablet with a high-fat meal decreased mirabegron peak plasma concentration (Cmax) and systemic exposure (AUC) by 45% and 17%, respectively, whereas administration with a low-fat meal decreased mirabegron Cmax and AUC by 75% and 51%, respectively. In phase 3 clinical studies demonstrating both safety and efficacy, mirabegron was administered without regards to food content and intake. Therefore, mirabegron can be taken with or without food at the recommended dosage.

References (1)
  1. (2012) "Product Information. Myrbetriq (mirabegron)." Astellas Pharma US, Inc

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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