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Drug Interactions between phenobarbital and remdesivir

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

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Interactions between your drugs

Moderate

PHENobarbital remdesivir

Applies to: phenobarbital and remdesivir

MONITOR: Theoretically, coadministration of remdesivir with potent inducers of CYP450 3A4 may decrease the plasma concentration of remdesivir, which has been shown in vitro to be a substrate of the isoenzyme. However, the potential for this interaction appears low as remdesivir's metabolism is predominantly mediated by hydrolysis via esterases in vivo, which are not significantly affected by CYP450 3A4. When a single dose of remdesivir (100 mg) was administered to healthy volunteers on carbamazepine (300 mg twice daily), remdesivir's peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 13% and 8%, respectively. One of remdesivir's metabolites (GS-704277) had no change in its Cmax or AUC, while its other metabolite (GS-441524) had a reduction in AUC of 17%.

MANAGEMENT: Caution and clinical monitoring may be advisable if remdesivir is administered concurrently with potent inducers of CYP450 3A4 as they may reduce its concentrations and effects. While clinically significant interactions are not expected, some authorities recommend avoiding concomitant use of remdesivir with potent CYP450 3A4 inducers.

References (4)
  1. (2023) "Product Information. Veklury (remdesivir)." Gilead Sciences Canada Inc
  2. (2024) "Product Information. Veklury (remdesivir)." Gilead Sciences Pty Ltd, 6
  3. (2024) "Product Information. Veklury (remdesivir)." Gilead Sciences Ltd
  4. (2024) "Product Information. Veklury (remdesivir)." Gilead Sciences

Drug and food interactions

Major

PHENobarbital food

Applies to: phenobarbital

GENERALLY AVOID: Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.

MANAGEMENT: The combination of ethanol and barbiturates should be avoided.

References (5)
  1. Gupta RC, Kofoed J (1966) "Toxological statistics for barbiturates, other sedatives, and tranquilizers in Ontario: a 10-year survey." Can Med Assoc J, 94, p. 863-5
  2. Misra PS, Lefevre A, Ishii H, Rubin E, Lieber CS (1971) "Increase of ethanol, meprobamate and pentobarbital metabolism after chronic ethanol administration in man and in rats." Am J Med, 51, p. 346-51
  3. Saario I, Linnoila M (1976) "Effect of subacute treatment with hypnotics, alone or in combination with alcohol, on psychomotor skills related to driving." Acta Pharmacol Toxicol (Copenh), 38, p. 382-92
  4. Stead AH, Moffat AC (1983) "Quantification of the interaction between barbiturates and alcohol and interpretation of fatal blood concentrations." Hum Toxicol, 2, p. 5-14
  5. Seixas FA (1979) "Drug/alcohol interactions: avert potential dangers." Geriatrics, 34, p. 89-102

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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