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Drug Interactions between nelfinavir and Sezaby

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

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Interactions between your drugs

Moderate

PHENobarbital nelfinavir

Applies to: Sezaby (phenobarbital) and nelfinavir

GENERALLY AVOID: Coadministration with phenobarbital is expected to decrease the plasma concentrations of nelfinavir. The proposed mechanism involves induction of the CYP450 3A4-mediated metabolism of nelfinavir by phenobarbital, which is considered a potent inducer of the isoenzyme. However, the interaction has not been reported in the medical literature, and no data are available from pharmacokinetic studies.

MANAGEMENT: Given the lack of pharmacokinetic data and the risk of reduced viral susceptibility and resistance development associated with subtherapeutic antiretroviral drug levels, it may be preferable to avoid using nelfinavir in combination with phenobarbital. Caution is advised if concomitant use is required. In patients already receiving nelfinavir as part of their HIV treatment regimen, close clinical and laboratory monitoring of antiretroviral response is recommended following the addition or discontinuation of phenobarbital.

References (3)
  1. (2001) "Product Information. Viracept (nelfinavir)." Agouron Pharma Inc
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink

Drug and food interactions

Major

PHENobarbital food

Applies to: Sezaby (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.

See also

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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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