Drug Interaction Report

MONITOR: Sedatives, tranquilizers, muscle relaxants, antidepressants, and other central nervous system (CNS) depressants may have additive CNS-depressant effects with aldesleukin. Aldesleukin has been associated with CNS effects including depression, confusion, and drowsiness, which may progress to coma.

MANAGEMENT: Caution is advised if aldesleukin is used with sedatives, hypnotics, tranquilizers, or other CNS-active medications. Patients should be monitored for CNS depression and other CNS adverse effects. Treatment with aldesleukin should be discontinued if severe lethargy or somnolence develop.

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of paliperidone. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

Administration with food may increase the bioavailability of paliperidone from the extended release tablets. In healthy ambulatory subjects, administration of a 12 mg paliperidone extended release tablet with a standard high-fat/high-caloric meal resulted in 60% and 54% increases, respectively, in the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of paliperidone compared to administration under fasting conditions. The clinical significance of these changes is unknown.

MANAGEMENT: Patients receiving paliperidone should be advised to avoid the consumption of alcohol. Since clinical trials establishing the safety and efficacy of paliperidone were carried out without regard to the timing of meals, presumably paliperidone may be administered with or without food.