Drug Interactions between Nuplazid and oliceridine

Consumer information for this interaction is not currently available.

MONITOR CLOSELY: Oliceridine can cause prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result in additive effects and increased risk of ventricular arrhythmias including torsade de pointes and sudden death. In a single-dose thorough QT study involving healthy subjects, dose-dependent QTc prolongation occurred after peak oliceridine plasma concentration at a therapeutic dose of 3 mg (7 msec [upper 90% confidence interval: 9 msec]) and a supratherapeutic dose of 6 mg (12 msec [upper 90% confidence interval: 14 msec]). In a multi-dose thorough QT study of healthy subjects who received intermittent oliceridine dosing over 24 hours to the maximum daily cumulative dose of 27 mg, the maximum mean increase in QTc was 11.7 msec (two-sided upper 90% confidence interval: 14.7 msec) at 9 hours. Despite continued dosing, QTc did not progressively increase and began to decrease after 12 hours. Daily cumulative doses greater than 27 mg have not been examined in a thorough QT study but may increase the risk for QT prolongation. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia, hypocalcemia). Moreover, the extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drug(s).

MANAGEMENT: Caution is recommended if oliceridine is used in combination with other drugs that can prolong the QT interval. The daily cumulative dose of oliceridine should not exceed 27 mg. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope.