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Drug Interactions between teduglutide and Xanax

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

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Interactions between your drugs

Moderate

ALPRAZolam teduglutide

Applies to: Xanax (alprazolam) and teduglutide

MONITOR: Coadministration with teduglutide may increase the absorption of oral medications. The mechanism is attributed to teduglutide's action to improve intestinal absorption. A patient receiving prazepam started teduglutide 0.05 mg/kg once a day and within the first week experienced a dramatic deterioration in mental status progressing to coma. A prazepam blood concentration was found to be greater than 300 mcg/L; both drugs were discontinued, and the coma resolved 5 days later.

MANAGEMENT: Monitor patients receiving concomitant oral drugs requiring titration or with a narrow therapeutic index for adverse reactions due to potential increased absorption. The dose of the concomitant drug may need to be reduced.

References

  1. (2013) "Product Information. Gattex (teduglutide)." NPS Pharmaceuticals

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Drug and food interactions

Moderate

ALPRAZolam food

Applies to: Xanax (alprazolam)

GENERALLY AVOID: The pharmacologic activity of oral midazolam, triazolam, and alprazolam may be increased if taken after drinking grapefruit juice. The proposed mechanism is CYP450 3A4 enzyme inhibition. In addition, acute alcohol ingestion may potentiate CNS depression and other CNS effects of many benzodiazepines. Tolerance may develop with chronic ethanol use. The mechanism may be decreased clearance of the benzodiazepines because of CYP450 hepatic enzyme inhibition. Also, it has been suggested that the cognitive deficits induced by benzodiazepines may be increased in patients who chronically consume large amounts of alcohol.

MANAGEMENT: The manufacturer recommends that grapefruit juice should not be taken with oral midazolam. Patients taking triazolam or alprazolam should be monitored for excessive sedation. Alternatively, the patient could consume orange juice which does not interact with these drugs. Patients should be advised to avoid alcohol during benzodiazepine therapy.

References

  1. (2002) "Product Information. Xanax (alprazolam)." Pharmacia and Upjohn
  2. (2002) "Product Information. Valium (diazepam)." Roche Laboratories
  3. (2001) "Product Information. Halcion (triazolam)." Pharmacia and Upjohn
  4. (1995) "Grapefruit juice interactions with drugs." Med Lett Drugs Ther, 37, p. 73-4
  5. Kupferschmidt HHT, Ha HR, Ziegler WH, Meier PJ, Krahenbuhl S (1995) "Interaction between grapefruit juice and midazolam in humans." Clin Pharmacol Ther, 58, p. 20-8
  6. Hukkinen SK, Varhe A, Olkkola KT, Neuvonen PJ (1995) "Plasma concentrations of triazolam are increased by concomitant ingestion of grapefruit juice." Clin Pharmacol Ther, 58, p. 127-31
  7. Bailey DG, Dresser GR, Kreeft JH, Munoz C, Freeman DJ, Bend JR (2000) "Grapefruit-felodipine interaction: Effect of unprocessed fruit and probable active ingredients." Clin Pharmacol Ther, 68, p. 468-77
View all 7 references

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Moderate

teduglutide food

Applies to: teduglutide

MONITOR: Teduglutide has the potential to increase absorption of concomitantly administered oral medications. Altered mental status in association with teduglutide treatment has been observed in patients on benzodiazepines in clinical trials. In one case, a patient who received prazepam with teduglutide 0.05 mg/kg/day experienced dramatic deterioration in mental status progressing to coma during her first week of teduglutide therapy. She was admitted to the intensive care unit, where her benzodiazepine level was found to exceed 300 mcg/L. Both medications were discontinued, and the coma resolved five days later.

MANAGEMENT: Careful monitoring and possible dosage adjustment of oral medications that require titration or have a narrow therapeutic index are recommended during coadministration with teduglutide.

References

  1. (2013) "Product Information. Gattex (teduglutide)." NPS Pharmaceuticals

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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.

See also

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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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