Drug Interactions between nicotine and sparsentan
This report displays the potential drug interactions for the following 2 drugs:
- nicotine
- sparsentan
Interactions between your drugs
nicotine sparsentan
Applies to: nicotine and sparsentan
MONITOR: Coadministration with sparsentan may decrease the plasma concentrations of drugs that are substrates of the CYP450 2B6, 2C9, and 2C19 isoenzymes. The proposed mechanism is increased clearance due to sparsentan-mediated induction of CYP450 2B6, 2C9, and 2C19. Concomitant use with sparsentan decreased the peak plasma concentration (Cmax) and the systemic exposure (AUC) of the CYP450 2B6 substrate bupropion by 32% and 33%, respectively.
MANAGEMENT: Caution is advised if sparsentan is to be used concomitantly with medications that undergo metabolism by CYP450 2B6, 2C9, and 2C19, particularly those with a narrow therapeutic range. Patients should be monitored for diminished therapeutic effects. Clinical and laboratory monitoring may be considered whenever sparsentan is added to or withdrawn from therapy with these drugs, and dosage may be adjusted in accordance with the prescribing Information.
References
- (2023) "Product Information. Filspari (sparsentan)." Travere Therapeutics Inc.
Drug and food interactions
sparsentan food
Applies to: sparsentan
GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of sparsentan, which is primarily metabolized by CYP450 3A4. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Inhibition of hepatic CYP450 3A4 may also contribute. The interaction has not been studied with grapefruit juice but has been reported for other CYP450 3A4 inhibitors. Concomitant use with potent CYP450 3A4 inhibitor itraconazole increased sparsentan peak plasma concentration (Cmax) and systemic exposure (AUC) by 25% and 174%, respectively. Increased exposure to sparsentan may increase the risk of hepatotoxicity, acute kidney injury, hyperkalemia, edema, and hypotension. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition.
MONITOR CLOSELY: Moderate-to-high dietary intake of potassium, especially salt substitutes, may increase the risk of hyperkalemia in some patients who are using an endothelin and angiotensin II receptor antagonist such as sparsentan. Sparsentan can promote hyperkalemia through inhibition of the renin-angiotensin-aldosterone system (RAAS). Patients with diabetes, heart failure, dehydration, or renal insufficiency have a greater risk of developing hyperkalemia.
Administration of a single oral dose of sparsentan 800 mg following a high-fat, high-calorie meal (1000 kcal, 50% fat), increased sparsentan AUC and Cmax by 22% and 108%, respectively. However, no clinically significant differences in sparsentan pharmacokinetics were observed following administration of a single 200 mg dose with a high-fat, high-calorie meal.
MANAGEMENT: It may be advisable for patients to avoid the consumption of grapefruit, grapefruit juice, or supplements that contain grapefruit during treatment with sparsentan. Patients should receive dietary counseling and be advised to not use potassium-containing salt substitutes or over-the-counter potassium supplements without consulting their physician. If salt substitutes are used concurrently, regular monitoring of serum potassium levels is recommended. Patients should also be advised to seek medical attention if they experience symptoms of hyperkalemia such as weakness, irregular heartbeat, confusion, tingling of the extremities, or feelings of heaviness in the legs. Advise patients to take the daily dose of sparsentan with water prior to either the morning or evening meal, and to maintain the same dosing schedule with respect to the time of day and in relation to meals.
References
- (2023) "Product Information. Filspari (sparsentan)." Travere Therapeutics Inc.
nicotine food
Applies to: nicotine
One study (n=12) has reported that there was a significant interactive effect of caffeine and nicotine on subjective arousal such that nicotine decreased arousal only in the presence of caffeine. The exact mechanism of this interaction has not been specified. Further research is needed to examine the subjective and physiological interactions between caffeine and nicotine.
References
- Rose JE, Behm FM (1991) "Psychophysiological interactions between caffeine and nicotine." Pharmacol Biochem Behav, 38, p. 333-7
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
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
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