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Drug Interactions between Orlaam and Penthrane

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

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Interactions between your drugs

Moderate

methoxyflurane levomethadyl acetate

Applies to: Penthrane (methoxyflurane) and Orlaam (levomethadyl acetate)

MONITOR: Opioids may decrease the minimum alveolar concentration required for inhalation anesthetics. When these agents are used concomitantly, less inhalation anesthetic may be required. In addition, inhalation anesthetics may cause respiratory depression which may be increased by opioid premedication or other agents causing respiratory depression.

MANAGEMENT: In general, anesthesia should be titrated to clinical effect by those experienced in anesthesia technique and in the care of patients receiving opioids. Patients should be monitored closely for respiratory depression. Supportive therapy should be provided if needed.

References

  1. (2001) "Product Information. Ultane (sevoflurane)." Abbott Pharmaceutical
  2. Inagaki Y, Kuzukawa A (1997) "Effects of epidural and intravenous buprenorphine on halothane minimum alveolar anesthetic concentration and hemodynamic responses." Anesth Analg, 84, p. 100-5

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Drug and food interactions

Major

levomethadyl acetate food

Applies to: Orlaam (levomethadyl acetate)

GENERALLY AVOID: The concurrent use of levomethadyl acetate and alcohol may result in additive CNS and respiratory depression, hypotension, sedation, or coma. Grapefruit juice may increase the plasma concentrations of orally administered drugs which are substrates of the CYP450 3A4 isoenzyme, such as levomethadyl acetate. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. The extent and clinical significance are unknown. Moreover, pharmacokinetic alterations associated with interactions involving grapefruit juice are often subject to a high degree of interpatient variability.

MANAGEMENT: Patients who are known to abuse alcohol should be warned of the risk of potentially fatal overdose if these substances are taken concurrently. Patients who regularly consume grapefruits and grapefruit juice should be monitored for adverse effects and altered plasma concentrations of levomethadyl acetate. A 12-lead ECG should be performed before initiating therapy, 12 to 14 days after initiating therapy, and periodically thereafter. Patients should be advised to immediately seek medical attention if they experience palpitations, dizziness, lightheadedness, fainting, or seizures. Grapefruits and grapefruit juice should be avoided if an interaction is suspected. Orange juice is not expected to interact.

References

  1. (2001) "Product Information. Orlaam (levomethadyl acetate)." Roxane Laboratories Inc

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Moderate

methoxyflurane food

Applies to: Penthrane (methoxyflurane)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of central nervous system (CNS)-active agents. Use in combination may result in additive CNS depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled against driving, operating machinery, or engaging in potentially hazardous activities requiring 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. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  4. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  5. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
View all 5 references

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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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