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Drug Interactions between Odomzo and torsemide

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

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Interactions between your drugs

Moderate

torsemide sonidegib

Applies to: torsemide and Odomzo (sonidegib)

MONITOR: Coadministration with inhibitors of CYP450 2C9 may increase the plasma concentrations of torsemide. The interaction has not been evaluated in pharmacokinetic studies; however, torsemide has been shown to undergo metabolism by CYP450 2C9.

MANAGEMENT: Caution is advised when torsemide is prescribed with CYP450 2C9 inhibitors. Patients should be monitored for potentially increased adverse effects such as dehydration, hypotension, electrolyte imbalances, hyperglycemia, tinnitus, and hearing loss.

References

  1. "Product Information. Demadex (torsemide)." Boehringer Mannheim
  2. Miners JO, Rees DLP, Valente L, Veronese ME, Birkett DJ (1995) "Human hepatic cytochrome p450 2c9 catalyzes the rate-limiting pathway of torsemide metabolism." J Pharmacol Exp Ther, 272, p. 1076-81
  3. Miners JO, Birkett DJ (1998) "Cytochrome P4502C9: an enzyme of major importance in human drug metabolism." Br J Clin Pharmacol, 45, p. 525-38
  4. Vormfelde SV, Engelhardt S, Zirk A, et al. (2004) "CYP2C9 polymorphisms and the interindividual variability in pharmacokinetics and pharmacodynamics of the loop diuretic drug torsemide." Clin Pharmacol Ther, 76, p. 557-66
View all 4 references

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Drug and food interactions

Moderate

sonidegib food

Applies to: Odomzo (sonidegib)

ADJUST DOSING INTERVAL: Food significantly increases the oral bioavailability of sonidegib. According to the product labeling, administration of sonidegib with a high-fat meal (approximately 1000 calories; 50% from fat) increased mean sonidegib peak plasma concentration (Cmax) and systemic exposure (AUC) by 7.4- to 7.8-fold.

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of sonidegib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. 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. Increased exposure to sonidegib may increase the risk of adverse effects such as musculoskeletal toxicity, fatigue, nausea, vomiting, diarrhea, anorexia, weight loss, alopecia, pruritus, and dysgeusia.

MANAGEMENT: Sonidegib should be administered on an empty stomach, at least 1 hour before or 2 hours after a meal. Patients should avoid consumption of grapefruit or grapefruit juice during treatment with sonidegib.

References

  1. (2015) "Product Information. Odomzo (sonidegib)." Novartis Pharmaceuticals

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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.


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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.