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Drug Interactions between paliperidone and sodium oxybate

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

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Interactions between your drugs

Major

sodium oxybate paliperidone

Applies to: sodium oxybate and paliperidone

GENERALLY AVOID: The central nervous system and respiratory depressant effects of sodium oxybate, which is the sodium salt of gamma hydroxybutyrate (GHB), may be potentiated by concomitant use of other agents with CNS depressant effects. An increased risk of serious adverse reactions such as respiratory depression, hypotension, profound sedation, syncope, coma, and even death should be considered.

MANAGEMENT: Concomitant use of sodium oxybate with other CNS depressants should be avoided whenever possible. Otherwise, close monitoring and/or dosage reductions should be considered. If short-term use of a CNS depressant is required (e.g., post- or perioperative opioid), a temporary interruption of sodium oxybate therapy may be appropriate. All patients treated with sodium oxybate should be advised not to drive, operate machinery, or engage in potentially hazardous activities requiring mental alertness and motor coordination for at least 6 hours after taking the second nightly dose of sodium oxybate and until they know how the medication affects them.

References (2)
  1. (2002) "Product Information. Xyrem (sodium oxybate)." Orphan Medical
  2. (2020) "Product Information. Xywav (calcium/magnesium/potass/sodium oxybates)." Jazz Pharmaceuticals

Drug and food interactions

Major

sodium oxybate food

Applies to: sodium oxybate

CONTRAINDICATED: Alcohol may potentiate the central nervous system and respiratory depressant effects of sodium oxybate, which is the sodium salt of gamma hydroxybutyrate (GHB). An increased risk of serious adverse reactions such as respiratory depression, hypotension, profound sedation, syncope, coma, and even death should be anticipated.

ADJUST DOSING INTERVAL: Food may delay the absorption and significantly decrease the bioavailability of sodium oxybate. When sodium oxybate was administered immediately after a high-fat meal, the time to reach peak plasma concentration (Tmax) increased from 0.75 hour to 2 hours, the peak plasma concentration (Cmax) decreased by a mean of 59%, and the systemic exposure (AUC) decreased by a mean of 37%.

MANAGEMENT: The concomitant use of sodium oxybate with alcohol is considered contraindicated. The first dose of sodium oxybate should be taken at least 2 hours after a meal to ensure maximal absorption.

References (1)
  1. (2002) "Product Information. Xyrem (sodium oxybate)." Orphan Medical
Moderate

paliperidone food

Applies to: paliperidone

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

Administration with food may increase the bioavailability of paliperidone from the extended release tablets. In healthy ambulatory subjects, administration of a 12 mg paliperidone extended release tablet with a standard high-fat/high-caloric meal resulted in 60% and 54% increases, respectively, in the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of paliperidone compared to administration under fasting conditions. The clinical significance of these changes is unknown.

MANAGEMENT: Patients receiving paliperidone should be advised to avoid the consumption of alcohol. Since clinical trials establishing the safety and efficacy of paliperidone were carried out without regard to the timing of meals, presumably paliperidone may be administered with or without food.

References (1)
  1. (2007) "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals

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.

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