Drug Interactions between Nourianz and riociguat

Chemical substances present in cigarette smoke may reduce the blood levels of riociguat. This means that the medication may be less effective if you smoke during treatment. Let your doctor know if you are a smoker, or if you start smoking or stop smoking during treatment with riociguat, because the dosage may need to be adjusted. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Food may affect the absorption and blood levels of riociguat. To avoid significant fluctuations in blood levels of the medication, riociguat should be taken about the same time each day consistently either with or without food.

Smoking tobacco may reduce the blood levels and effects of istradefylline. Contact your doctor if istradefylline is not adequately controlling your symptoms. It is best to avoid smoking during istradefylline therapy. Talk to a healthcare professional if you have any questions or concerns. If you start smoking or undergo smoking cessation, your doctor may need to monitor you more closely to determine if you need a dose adjustment of istradefylline. Your doctor may already be aware of the risks and may have taken appropriate precautions including adjusting your dose and monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.