Drug Interactions between Prevacid NapraPAC and resmetirom

GENERALLY AVOID: Theoretically, proton pump inhibitors may decrease the gastrointestinal absorption of enteric-coated naproxen, which requires an acidic environment for dissolution. The proposed mechanism is an increase in gastric pH (i.e. decreased gastric acidity) induced by proton pump inhibitors. In patients treated with proton pump inhibitors, the possibility of a reduced or subtherapeutic response to enteric-coated naproxen should be considered.

MANAGEMENT: Concomitant use of these drugs is generally not recommended.

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MONITOR: Coadministration with resmetirom may increase the plasma concentrations and the risk of adverse effects of drugs that are substrates of the CYP450 2C8 isoenzyme. The proposed mechanism, based on in vitro and clinical data, is decreased clearance due to weak inhibition of CYP450 2C8 by resmetirom. In healthy study subjects, when a single dose of the CYP450 2C8 substrate pioglitazone (15 mg) was administered with resmetirom at steady state concentrations (100 mg daily), a 1.5-fold increase in pioglitazone systemic exposure (AUC) was observed. However, the peak plasma concentration (Cmax) of pioglitazone was unchanged.

MANAGEMENT: Caution and clinical monitoring is recommended if resmetirom is coadministered with drugs that are substrates of the CYP450 2C8 isoenzyme. Dosage adjustments as well as closer clinical and laboratory monitoring for the development of adverse effects may be appropriate for some drugs whenever resmetirom is added to or withdrawn from therapy. Individual product labeling should be consulted for further guidance.

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