Drug Interaction Report

MONITOR: Coadministration of lasmiditan and agents that lower heart rate may increase the risk of bradycardia. In clinical trials, lasmiditan was associated with heart rate decreases of 5 to 10 beats per minute (bpm) while placebo was associated with decreases of 2 to 5 bpm. In a drug interaction study, a single 200 mg dose of lasmiditan led to an additional heart rate decrease of 5 bpm when given with propranolol.

MANAGEMENT: Caution is advised during coadministration of lasmiditan and agents that lower heart rate if the estimated decrease in heart rate may present a clinical risk. Consider monitoring heart rate in patients for whom the estimated decrease in heart rate may not be tolerated.

H2 antagonists may reduce the clearance of nicotine. Cimetidine, 600 mg given twice a day for two days, reduced clearance of an intravenous nicotine dose by 30%. Ranitidine, 300 mg given twice a day for two days, reduced clearance by 10%. The clinical significance of this interaction is not known. Patients should be monitored for increased nicotine effects when using the patches or gum for smoking cessation and dosage adjustments should be made as appropriate.