Drug Interaction Report
3 potential interactions and/or warnings found for the following 2 drugs:
- fluoxetine
- trospium / xanomeline
Interactions between your drugs
FLUoxetine xanomeline
Applies to: fluoxetine, trospium / xanomeline
MONITOR: Coadministration with potent inhibitors of CYP450 2D6 may increase the plasma concentrations as well as the pharmacologic and adverse effects of xanomeline. The proposed mechanism involves the inhibition of CYP450 2D6, an isoenzyme significantly responsible for the metabolic clearance of xanomeline. Furthermore, because CYP450 2D6 is genetically polymorphic, variations in xanomeline metabolism across populations may either increase or decrease the risk associated with this interaction. Increased exposure to xanomeline may potentiate the risk of adverse reactions such as nausea, dyspepsia, vomiting, abdominal pain, diarrhea and gastrointestinal reflux disease. However, data evaluating the interaction are not available.
MANAGEMENT: Caution and closer monitoring for adverse effects are recommended if xanomeline is used concurrently with potent CYP450 2D6 inhibitors.
References (1)
- (2024) "Product Information. Cobenfy (trospium-xanomeline)." Bristol-Myers Squibb
Drug and food interactions
FLUoxetine food
Applies to: fluoxetine
GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.
MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
References (4)
- Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
- Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
- (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
trospium food
Applies to: trospium / xanomeline
ADJUST DOSING INTERVAL: Food may reduce the oral absorption and bioavailability of trospium chloride. According to the product labeling, administration of trospium chloride with a high fat meal reduced the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 70% to 80% compared to administration while fasting.
MANAGEMENT: To ensure maximal oral absorption, trospium chloride should be administered at least 1 hour before meals or on an empty stomach. If trospium chloride is administered as a combination with xanomeline, the manufacturer recommends administering the capsules at least 1 hour before a meal or at least 2 hours after a meal. Capsules should be taken whole.
References (5)
- (2012) "Product Information. Sanctura (trospium)." Odyssey Pharmaceuticals
- (2024) "Product Information. Cobenfy (trospium-xanomeline)." Bristol-Myers Squibb
- (2019) "Product Information. Trosec (trospium)." Oryx Pharmaceuticals Inc
- (2022) "Product Information. Regurin (trospium)." Mylan Healthcare Sdn. Bhd.
- (2023) "Product Information. Trospium Chloride (trospium)." Padagis
Therapeutic duplication warnings
No duplication 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.
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. |
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Further information
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