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Drug Interactions between riociguat and Riopan Plus Double Strength

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

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Interactions between your drugs

Moderate

magaldrate riociguat

Applies to: Riopan Plus Double Strength (magaldrate / simethicone) and riociguat

ADJUST DOSING INTERVAL: Concurrent administration of riociguat with antacids may reduce its gastrointestinal absorption. Riociguat exhibits pH-dependent solubility, with increased solubility at lower pH. According to the product labeling, administration of riociguat with an antacid containing aluminum hydroxide and magnesium hydroxide resulted in decreases of riociguat peak plasma concentration (Cmax) and systemic exposure (AUC) by approximately 50% and 30%, respectively. The Cmax and AUC of the active metabolite, M1, which has 1/3 to 1/10 the pharmacologic activity of riociguat, were similarly reduced.

MANAGEMENT: Antacids should not be taken within 1 hour of riociguat administration.

References

  1. "Product Information. Adempas (riociguat)." Bayer Pharmaceutical Inc (2013):

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Drug and food interactions

Moderate

riociguat food

Applies to: riociguat

ADJUST DOSE: Smoking may decrease the plasma concentrations of riociguat. The proposed mechanism is induction of the CYP450 1A1-mediated metabolism of riociguat by polycyclic aromatic hydrocarbons present in cigarette smoke. CYP450 1A1 is responsible for the formation of the major active metabolite, M1, which has just 1/3 to 1/10 the pharmacologic activity of riociguat. According to the product labeling, plasma concentrations of riociguat are reduced by 50% to 60% in smokers compared to nonsmokers.

MANAGEMENT: Riociguat dosages higher than 2.5 mg three times a day may be considered in cigarette smokers, if tolerated, so as to match the exposure seen in nonsmoking patients. However, safety and effectiveness of higher dosages have not been established. A dosage reduction should be considered in patients who stop smoking during treatment with riociguat.

References

  1. "Product Information. Adempas (riociguat)." Bayer Pharmaceutical Inc (2013):

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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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