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Drug Interaction Report

2 potential interactions and/or warnings found for the following 2 drugs:

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Interactions between your drugs

Moderate

thiabendazole obeticholic acid

Applies to: Mintezol (thiabendazole), obeticholic acid

MONITOR: Coadministration with obeticholic acid may increase the plasma concentrations of drugs that are substrates of the CYP450 1A2 isoenzyme. The mechanism is decreased clearance due to inhibition of CYP450 1A2 activity by obeticholic acid and its glycine and taurine conjugates. When a single 200 mg dose of caffeine (a probe CYP450 1A2 substrate) was administered with obeticholic acid 10 mg once daily, caffeine peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 6% and 42%, respectively.

MANAGEMENT: Caution is advised when obeticholic acid is prescribed with drugs that undergo metabolism by CYP450 1A2, particularly those with a narrow therapeutic range such as theophylline or tizanidine. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever obeticholic acid is added to or withdrawn from therapy.

References (1)
  1. (2016) "Product Information. Ocaliva (obeticholic acid)." Intercept Pharmaceuticals, Inc.

Drug and food interactions

Moderate

thiabendazole food

Applies to: Mintezol (thiabendazole)

MONITOR: Coadministration with thiabendazole may increase the plasma concentrations of caffeine. The mechanism is thiabendazole inhibition of the CYP450 1A2 metabolism of caffeine. In ten healthy, nonsmoking volunteers, administration of a single 136.5 mg dose of caffeine in combination with a single 500 mg dose of thiabendazole resulted in a nearly 60% increase in the area under the plasma concentration-time curve (AUC) of caffeine compared to administration without thiabendazole. In addition, the half-life of caffeine was increased from 11.9 to 28.6 hours, and oral clearance was reduced by 67% during coadministration with thiabendazole. The formation of paraxanthine from caffeine, which is primarily mediated by CYP450 1A2, was almost completely abolished until after the thiabendazole was cleared from the system.

MANAGEMENT: Patients should be advised that pharmacologic effects of caffeine may be increased during coadministration with thiabendazole.

References (2)
  1. Bapiro TE, Sayi J, Hasler JA, et al. (2005) "Artemisinin and thiabendazole are potent inhibitors of cytochrome P450 1A2 (CYP1A2) activity in humans." Eur J Clin Pharmacol, 61, p. 755-61

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.


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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.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.