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Drug Interactions between nitazoxanide and Valproate Sodium

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

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Interactions between your drugs

Moderate

valproic acid nitazoxanide

Applies to: Valproate Sodium (valproic acid) and nitazoxanide

MONITOR: Coadministration with nitazoxanide may increase the free plasma concentrations of drugs and/or their active metabolites that are highly bound to plasma proteins. The pharmacologic effects of some drugs may be increased by this interaction. The proposed mechanism is competitive displacement from protein binding sites by tizoxanide, the active metabolite of nitazoxanide that is greater than 99.9% bound to plasma proteins.

MANAGEMENT: Caution is advised when other highly protein-bound drugs are used with nitazoxanide, particularly those with a narrow therapeutic index. Patients should be monitored more closely following the addition or withdrawal of nitazoxanide. When performing therapeutic drug monitoring, total plasma concentrations should be interpreted cautiously due to the possibility of increased free (unbound) drug.

References

  1. (2002) "Product Information. Alinia (nitazoxanide)." Romark Laboratories L.C.

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Drug and food interactions

Moderate

valproic acid food

Applies to: Valproate Sodium (valproic acid)

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

  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
View all 4 references

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Moderate

nitazoxanide food

Applies to: nitazoxanide

ADJUST DOSING INTERVAL: Food enhances the bioavailability of the pharmacologically active metabolite tizoxanide (desacetyl-nitazoxamide) from nitazoxanide administration. According to the product labeling, administration of nitazoxanide tablets with food increases the area under the plasma concentration-time curve (AUC) of tizoxanide and tizoxanide glucuronide in plasma by almost 2-fold and the peak plasma concentration (Cmax) by almost 50%. Administration of nitazoxanide oral suspension with food increases the AUC of tizoxanide and tizoxandie glucuronide by about 45% to 50% and the Cmax by less than 10%.

MANAGEMENT: Nitazoxanide tablets and oral suspension were administered with food in clinical trials and are recommended to be administered with food to ensure maximal drug levels in plasma.

References

  1. (2002) "Product Information. Alinia (nitazoxanide)." Romark Laboratories L.C.

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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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