Can you take Pitolisant with Sodium phenylbutyrate / taurursodiol?
1 drug interaction and 21 additional warnings found for the following 2 drugs:
- pitolisant
- sodium phenylbutyrate/taurursodiol
Drug interactions
Moderate drug interactions
Moderate:
pitolisant taurursodiol
Applies to: pitolisant and sodium phenylbutyrate / taurursodiol
Taurursodiol may increase the blood levels and effects of pitolisant. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
sodium phenylbutyrate Food/Lifestyle
Applies to: sodium phenylbutyrate / taurursodiol
Food may affect the absorption of sodium phenylbutyrate. A high-fat, high-calorie meal (approximately 800 to 1000 calories; 500 to 600 calories from fat, 250 calories from carbohydrate, 150 calories from protein) has been shown to reduce the absorption of sodium phenylbutyrate, although it is unknown what impact this may have on the overall effectiveness of the medication. The manufacturer recommends taking sodium phenylbutyrate before a meal or snack. This is especially important if you weigh less than 70 kg (approximately 154 pounds). Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.
Disease interactions
20 potential interactions Applies to: 15 conditions, including Depression, Heart Failure, Peripheral Neuropathy, Arrhythmia, and Hypokalemia.
Arrhythmia
Moderate:
pitolisant
Pitolisant has a moderate potential interaction with Arrhythmia.
Pitolisant prolongs the QT interval. The use of pitolisant should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong the QT interval. The use of pitolisant should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and the presence of congenital prolongation of the QT interval. The risk of QT prolongation may be greater in patients with hepatic or renal impairment due to higher concentrations of pitolisant. It is recommended to monitor patients with hepatic or renal impairment for increased QTc. Exercise care when using this agent in patients with these conditions.
Biliary Obstruction
Moderate:
sodium phenylbutyrate / taurursodiol
The taurursodiol in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Biliary Obstruction.
Sodium phenylbutyrate-taurursodiol contains taurursodiol, a bile acid. In patients with disorders that interfere with bile acid circulation, there may be an increased risk for diarrhea and patients should be monitored appropriately. Other conditions such as pancreatic insufficiency, intestinal malabsorption, or intestinal diseases that may alter the concentration of bile acids, may also lead to decreased absorption of this drug and its components. Consider consulting with a GI specialists with experience managing these GI disorders. Patients with disorders of enterohepatic circulation (e.g., biliary infection, active cholecystitis, etc.), severe pancreatic disorders (e.g., pancreatitis), and intestinal disorders that may alter concentrations of bile acids (e.g., ileal resection, regional ileitis, etc.) were excluded from clinical studies and there is no experience in patients with these conditions. Caution is advised.
Central Nervous System Disorders
Moderate:
sodium phenylbutyrate / taurursodiol
The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Central Nervous System Disorders.
Sodium phenylbutyrate is a pro-drug and is rapidly metabolized to the active, phenylacetate. Neurotoxicity, including exacerbation of a preexisting neuropathy, has been reported with the use of intravenous phenylacetate. The acute onset and reversibility when the phenylacetate infusion was discontinued suggested a drug effect. Care should be exercised when prescribing sodium phenylbutyrate to patients at risk for neurotoxicity.
Depression
Major:
pitolisant
Pitolisant has a major potential interaction with Depression.
The use of CNS stimulants can cause psychotic symptoms, suicidal ideation, and aggression, and can exacerbate symptoms of behavior disturbance and thought disorder; CNS stimulants may induce a manic or mixed episode in patients with bipolar disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders. All patients (particularly those with psychotic or bipolar disorders) should be monitored closely, especially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. Prior to initiating therapy, all patients should be screened for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or family history of suicide, bipolar disease, or depression). If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. Some CNS stimulants are contraindicated in patients with marked agitation or anxiety.
Fluid Retention
Major:
sodium phenylbutyrate / taurursodiol
The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a major potential interaction with Fluid Retention.
The use of sodium phenylbutyrate may cause fluid retention in patients with congestive heart failure, renal dysfunction, or sodium retention with edema. Sodium phenylbutyrate is primarily excreted by the kidney and these patients may exhibit reduced excretion. Therapy with sodium phenylbutyrate should be administered cautiously in these patients. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.
Gallbladder Disease
Moderate:
sodium phenylbutyrate / taurursodiol
The taurursodiol in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Gallbladder Disease.
Sodium phenylbutyrate-taurursodiol contains taurursodiol, a bile acid. In patients with disorders that interfere with bile acid circulation, there may be an increased risk for diarrhea and patients should be monitored appropriately. Other conditions such as pancreatic insufficiency, intestinal malabsorption, or intestinal diseases that may alter the concentration of bile acids, may also lead to decreased absorption of this drug and its components. Consider consulting with a GI specialists with experience managing these GI disorders. Patients with disorders of enterohepatic circulation (e.g., biliary infection, active cholecystitis, etc.), severe pancreatic disorders (e.g., pancreatitis), and intestinal disorders that may alter concentrations of bile acids (e.g., ileal resection, regional ileitis, etc.) were excluded from clinical studies and there is no experience in patients with these conditions. Caution is advised.
Heart Failure
Major:
sodium phenylbutyrate / taurursodiol
The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a major potential interaction with Heart Failure.
The use of sodium phenylbutyrate may cause fluid retention in patients with congestive heart failure, renal dysfunction, or sodium retention with edema. Sodium phenylbutyrate is primarily excreted by the kidney and these patients may exhibit reduced excretion. Therapy with sodium phenylbutyrate should be administered cautiously in these patients. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.
Hypokalemia
Moderate:
pitolisant
Pitolisant has a moderate potential interaction with Hypokalemia.
Pitolisant prolongs the QT interval. The use of pitolisant should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong the QT interval. The use of pitolisant should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and the presence of congenital prolongation of the QT interval. The risk of QT prolongation may be greater in patients with hepatic or renal impairment due to higher concentrations of pitolisant. It is recommended to monitor patients with hepatic or renal impairment for increased QTc. Exercise care when using this agent in patients with these conditions.
Liver Disease
Major:
pitolisant
Pitolisant has a major potential interaction with Liver Disease.
Pitolisant is contraindicated in patients with severe hepatic impairment. Pitolisant is extensively metabolized by the liver. Care should be exercised when using pitolisant in patients with moderate hepatic impairment. It is recommended to monitor patients with mild and moderate hepatic impairment and to adjust the dosage of pitolisant in patients with moderate hepatic impairment as appropriate. No dosage adjustment is recommended in patients with mild hepatic impairment.
Moderate:
pitolisant
Pitolisant has a moderate potential interaction with Liver Disease.
Pitolisant prolongs the QT interval. The use of pitolisant should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong the QT interval. The use of pitolisant should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and the presence of congenital prolongation of the QT interval. The risk of QT prolongation may be greater in patients with hepatic or renal impairment due to higher concentrations of pitolisant. It is recommended to monitor patients with hepatic or renal impairment for increased QTc. Exercise care when using this agent in patients with these conditions.
Moderate:
sodium phenylbutyrate / taurursodiol
The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Liver Disease.
Sodium phenylbutyrate is primarily metabolized in the liver and kidney. Therapy with sodium phenylbutyrate should be administered cautiously in patients with liver disease. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.
Magnesium Imbalance
Moderate:
pitolisant
Pitolisant has a moderate potential interaction with Magnesium Imbalance.
Pitolisant prolongs the QT interval. The use of pitolisant should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong the QT interval. The use of pitolisant should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and the presence of congenital prolongation of the QT interval. The risk of QT prolongation may be greater in patients with hepatic or renal impairment due to higher concentrations of pitolisant. It is recommended to monitor patients with hepatic or renal impairment for increased QTc. Exercise care when using this agent in patients with these conditions.
Malabsorption Syndrome
Moderate:
sodium phenylbutyrate / taurursodiol
The taurursodiol in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Malabsorption Syndrome.
Sodium phenylbutyrate-taurursodiol contains taurursodiol, a bile acid. In patients with disorders that interfere with bile acid circulation, there may be an increased risk for diarrhea and patients should be monitored appropriately. Other conditions such as pancreatic insufficiency, intestinal malabsorption, or intestinal diseases that may alter the concentration of bile acids, may also lead to decreased absorption of this drug and its components. Consider consulting with a GI specialists with experience managing these GI disorders. Patients with disorders of enterohepatic circulation (e.g., biliary infection, active cholecystitis, etc.), severe pancreatic disorders (e.g., pancreatitis), and intestinal disorders that may alter concentrations of bile acids (e.g., ileal resection, regional ileitis, etc.) were excluded from clinical studies and there is no experience in patients with these conditions. Caution is advised.
Myoneural Disorder
Moderate:
sodium phenylbutyrate / taurursodiol
The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Myoneural Disorder.
Sodium phenylbutyrate is a pro-drug and is rapidly metabolized to the active, phenylacetate. Neurotoxicity, including exacerbation of a preexisting neuropathy, has been reported with the use of intravenous phenylacetate. The acute onset and reversibility when the phenylacetate infusion was discontinued suggested a drug effect. Care should be exercised when prescribing sodium phenylbutyrate to patients at risk for neurotoxicity.
Peripheral Neuropathy
Moderate:
sodium phenylbutyrate / taurursodiol
The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Peripheral Neuropathy.
Sodium phenylbutyrate is a pro-drug and is rapidly metabolized to the active, phenylacetate. Neurotoxicity, including exacerbation of a preexisting neuropathy, has been reported with the use of intravenous phenylacetate. The acute onset and reversibility when the phenylacetate infusion was discontinued suggested a drug effect. Care should be exercised when prescribing sodium phenylbutyrate to patients at risk for neurotoxicity.
Psychosis
Major:
pitolisant
Pitolisant has a major potential interaction with Psychosis.
The use of CNS stimulants can cause psychotic symptoms, suicidal ideation, and aggression, and can exacerbate symptoms of behavior disturbance and thought disorder; CNS stimulants may induce a manic or mixed episode in patients with bipolar disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders. All patients (particularly those with psychotic or bipolar disorders) should be monitored closely, especially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. Prior to initiating therapy, all patients should be screened for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or family history of suicide, bipolar disease, or depression). If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. Some CNS stimulants are contraindicated in patients with marked agitation or anxiety.
Renal Dysfunction
Major:
sodium phenylbutyrate / taurursodiol
The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a major potential interaction with Renal Dysfunction.
The use of sodium phenylbutyrate may cause fluid retention in patients with congestive heart failure, renal dysfunction, or sodium retention with edema. Sodium phenylbutyrate is primarily excreted by the kidney and these patients may exhibit reduced excretion. Therapy with sodium phenylbutyrate should be administered cautiously in these patients. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.
Moderate:
pitolisant
Pitolisant has a moderate potential interaction with Renal Dysfunction.
Pitolisant prolongs the QT interval. The use of pitolisant should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong the QT interval. The use of pitolisant should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and the presence of congenital prolongation of the QT interval. The risk of QT prolongation may be greater in patients with hepatic or renal impairment due to higher concentrations of pitolisant. It is recommended to monitor patients with hepatic or renal impairment for increased QTc. Exercise care when using this agent in patients with these conditions.
Moderate:
pitolisant
Pitolisant has a moderate potential interaction with Renal Dysfunction.
The pharmacokinetics of pitolisant in patients with end-stage renal disease (ESRD) (eGFR of <15 mL/minute/1.73 m2) is unknown. Pitolisant is not recommended in patients with ESRD. It is recommended to adjust the dosage of pitolisant when using this agent in patients with moderate (eGFR 30 to 59 mL/minute/1.73 m2) and severe (eGFR 15 to 29 mL/minute/1.73 m2) renal impairment.
Moderate:
sodium phenylbutyrate / taurursodiol
The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Renal Dysfunction.
Sodium phenylbutyrate is primarily metabolized in the liver and kidney. Therapy with sodium phenylbutyrate should be administered cautiously in patients with liver disease. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.
More resources
pitolisant
A total of 528 drugs are known to interact with pitolisant.
- Pitolisant is in the drug class miscellaneous central nervous system agents.
- Pitolisant is used to treat Narcolepsy.
sodium phenylbutyrate / taurursodiol
A total of 590 drugs are known to interact with sodium phenylbutyrate / taurursodiol.
- Sodium phenylbutyrate / taurursodiol is in the drug class miscellaneous central nervous system agents.
- Sodium phenylbutyrate / taurursodiol is used to treat Amyotrophic Lateral Sclerosis.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.