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Drug Interactions between riociguat and Sivextro

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

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Interactions between your drugs

Moderate

riociguat tedizolid

Applies to: riociguat and Sivextro (tedizolid)

GENERALLY AVOID: Coadministration with oral tedizolid may increase the plasma concentrations and the risk of adverse effects of orally administered drugs that are substrates of the breast cancer resistance protein (BCRP) transporter. The proposed mechanism is decreased clearance due to inhibition of BCRP-mediated intestinal efflux by tedizolid. Administration of a single 10 mg dose of rosuvastatin, a known BCRP substrate, to healthy subjects who had received multiple daily doses of tedizolid 200 mg increased rosuvastatin peak plasma concentration (Cmax) and systemic exposure (AUC) by 55% and 70%, respectively.

MANAGEMENT: Consider temporarily interrupting treatment with the BCRP substrate during treatment with tedizolid, especially for BCRP substrates with a narrow therapeutic index. If coadministration cannot be avoided, monitor for adverse reactions related to concomitantly administered BCRP substrate. The prescribing information for concomitant medications should be consulted to assess the benefits versus risks of coadministration and for any dosage adjustments that may be required.

References (2)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. (2014) "Product Information. Sivextro (tedizolid)." Cubist Pharmaceuticals Inc

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: Patients should be advised to stop smoking. Riociguat dosages higher than 2.5 mg three times a day may be considered in cigarette smokers, if tolerated, 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. The tablet form of riociguat can generally be taken with or without food. Some authorities recommend not to switch between fed and fasted riociguat intake because of increased peak plasma levels of riociguat in the fasting compared to the fed state.

References (3)
  1. (2013) "Product Information. Adempas (riociguat)." Bayer Pharmaceutical Inc
  2. (2023) "Product Information. Adempas (riociguat)." Merck Sharp & Dohme (UK) Ltd
  3. (2014) "Product Information. Adempas (riociguat)." Bayer Australia Limited

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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