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Drug Interactions between pimozide and Xolremdi

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

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Interactions between your drugs

Major

pimozide mavorixafor

Applies to: pimozide and Xolremdi (mavorixafor)

Consumer information for this interaction is not currently available.

CONTRAINDICATED: Coadministration with inhibitors of CYP450 2D6 may increase the plasma concentrations of pimozide, which is partially metabolized by the isoenzyme. In a controlled study of healthy volunteers, administration of pimozide (2 mg single dose) with the potent inhibitor paroxetine (60 mg daily) resulted in mean increases of 62% and 151% in pimozide peak plasma concentration (Cmax) and systemic exposure (AUC), respectively, compared to pimozide given alone. Quinidine, another potent inhibitor of CYP450 2D6, has been shown in vitro to also inhibit the metabolism of pimozide. The use of pimozide has been associated with dose-related prolongation of the QT interval, thus elevated plasma levels of the drug may potentiate the risk of ventricular arrhythmias such as ventricular tachycardia and torsade de pointes as well as cardiac arrest and sudden death.

MANAGEMENT: Due to the narrow therapeutic index of pimozide, the manufacturers consider its use with potent CYP450 2D6 inhibitors to be contraindicated.

Drug and food interactions

Major

pimozide food

Applies to: pimozide

You should avoid the consumption of large amounts of grapefruits and grapefruit juice while taking pimozide. Grapefruit can raise the levels of pimozide in your body. This can affect the rhythm of your heart and cause other side effects. Call your doctor if you have symptoms of blurred vision or nausea. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or fast or pounding heartbeats during treatment with pimozide. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. You should avoid or limit the use of alcohol while being treated with pimozide. Alcohol can increase the nervous system side effects of pimozide such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Major

mavorixafor food

Applies to: Xolremdi (mavorixafor)

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Grapefruit products may significantly increase the plasma concentrations and effects of mavorixafor, which is primarily metabolized by the isoenzyme CYP450 3A4. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. A study examining mavorixafor in combination with the strong CYP450 3A4 and P-glycoprotein inhibitor, itraconazole, suggests an increase in mavorixafor's systemic exposure (AUC) of approximately 2-fold. Clinical data with grapefruit products are not available. Pharmacokinetic interactions involving grapefruit are subject to a high degree of interpatient variability and can also be affected by the product and amount consumed; therefore, the extent to which a given patient may be affected is difficult to predict. Additionally, since mavorixafor is associated with concentration-dependent prolongation of the QT interval, increased levels may potentiate the risk of ventricular arrhythmias such as torsade de pointes and sudden death.

ADJUST DOSING INTERVAL: Food may significantly reduce the peak plasma concentration (Cmax) and systemic exposure (AUC) of mavorixafor. When a single-dose of mavorixafor (400 mg) was administered with a high-fat meal (1000 calories, 50% fat) to healthy subjects, the Cmax and AUC decreased by 66% and 55%, respectively. Similarly, when the same dose was given with a low-fat meal (500 calories, 25% fat) to healthy subjects, mavorixafor's Cmax and AUC decreased by 55% and 51%, respectively. Additionally, a single dose of mavorixafor (400 mg) administered with a low-fat meal to healthy subjects following an overnight fast resulted in a 14% higher Cmax and an 18% lower AUC than those obtained from subjects who fasted for an additional 4 hours after the dose.

MANAGEMENT: Mavorixafor should be taken on an empty stomach after an overnight fast, 30 minutes before food. Patients should be advised to avoid eating or drinking products containing grapefruit, as this could increase the risk of experiencing adverse effects from mavorixafor such as QT prolongation.

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.