Drug Interaction Report

Darunavir has a moderate potential interaction with Abnormal Glucose Tolerance.

New onset diabetes mellitus, exacerbation of preexisting diabetes mellitus, hyperglycemia, and some cases of diabetic ketoacidosis have been reported during postmarketing surveillance in HIV-infected patients treated with protease inhibitors. Some patients required either initiation or dosage adjustments of insulin or oral hypoglycemic agents for treatment of these events. In some cases, hyperglycemia persisted despite discontinuation of protease inhibitor therapy. A causal relationship has not been established between protease inhibitor therapy and these events. Monitoring patients for hyperglycemia, new onset diabetes mellitus, or exacerbation of diabetes mellitus should be considered during protease inhibitor therapy.

Armodafinil has a moderate potential interaction with Alcoholism.

Patients with excessive sleepiness, including those taking armodafinil, should be frequently reassessed for their degree of sleepiness and, if appropriate, advised to avoid driving or any other potentially dangerous activity. Patients should refrain from drinking alcohol while taking armodafinil as any drug affecting the central nervous system (CNS) may alter judgment, thinking or motor skills.

Armodafinil has a moderate potential interaction with Cardiovascular Conditions and Disorders.

Armodafinil may cause ECG changes, chest pain, or arrhythmia. Armodafinil should be used with caution in patients with cardiovascular complications. Armodafinil should not be used in patients with a history of left ventricular hypertrophy or in patients with mitral valve prolapse who have experienced the mitral valve prolapse syndrome when previously receiving CNS stimulants. It is recommended to monitor heart rate and blood pressure during treatment with armodafinil. Caution should be exercised when prescribing armodafinil to patients with known cardiovascular disease.

Darunavir has a moderate potential interaction with Coagulation Defects and Disorders.

There have been reports of increased bleeding, including spontaneous skin hematomas and hemarthrosis, in patients with hemophilia type A and B treated with protease inhibitors; however, a causal relationship has not been established. In some patients, additional factor VIII was given. In more than half of the reported cases, protease inhibitor therapy was continued or reintroduced. Patients with hemophilia or other coagulation defects should be monitored closely for bleeding during protease inhibitor therapy.

Armodafinil has a major potential interaction with Depression.

The use of CNS stimulants can cause psychotic symptoms, suicidal ideation, and aggression, and can exacerbate symptoms of behavior disturbance and thought disorder; CNS stimulants may induce a manic or mixed episode in patients with bipolar disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders. All patients (particularly those with psychotic or bipolar disorders) should be monitored closely, especially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. Prior to initiating therapy, all patients should be screened for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or family history of suicide, bipolar disease, or depression). If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. Some CNS stimulants are contraindicated in patients with marked agitation or anxiety.

Armodafinil has a moderate potential interaction with Depression.

Armodafinil may cause adverse psychiatric reactions. Caution should be exercised when using this agent in patients with a history of psychosis, depression, or mania. If psychiatric symptoms develop in association with armodafinil administration, consider discontinuing armodafinil. Close monitoring of psychiatric symptoms is recommended.

Darunavir has a moderate potential interaction with Diabetes Mellitus.

New onset diabetes mellitus, exacerbation of preexisting diabetes mellitus, hyperglycemia, and some cases of diabetic ketoacidosis have been reported during postmarketing surveillance in HIV-infected patients treated with protease inhibitors. Some patients required either initiation or dosage adjustments of insulin or oral hypoglycemic agents for treatment of these events. In some cases, hyperglycemia persisted despite discontinuation of protease inhibitor therapy. A causal relationship has not been established between protease inhibitor therapy and these events. Monitoring patients for hyperglycemia, new onset diabetes mellitus, or exacerbation of diabetes mellitus should be considered during protease inhibitor therapy.

Darunavir has a major potential interaction with Liver Disease.

Drug-induced hepatitis has been reported with the use of darunavir/ritonavir. Patients with underlying liver disease including chronic active hepatitis B or C viral infections have an increased risk for liver function abnormalities. Therapy with darunavir should be administered cautiously in patients with preexisting liver disease, liver enzyme abnormalities, or hepatitis. The combination of darunavir/ritonavir is not recommended for use in patients with severe hepatic impairment.

Armodafinil has a moderate potential interaction with Liver Disease.

In a study to determine the pharmacokinetics and metabolism of armodafinil in patients with cirrhosis, the oral clearance of armodafinil was decreased by about 60%, and the steady state concentration was doubled compared to healthy patients. The dosage of armodafinil should be reduced in patients with severe hepatic impairment. Close monitoring is recommended.

Armodafinil has a major potential interaction with Psychosis.

The use of CNS stimulants can cause psychotic symptoms, suicidal ideation, and aggression, and can exacerbate symptoms of behavior disturbance and thought disorder; CNS stimulants may induce a manic or mixed episode in patients with bipolar disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders. All patients (particularly those with psychotic or bipolar disorders) should be monitored closely, especially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. Prior to initiating therapy, all patients should be screened for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or family history of suicide, bipolar disease, or depression). If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. Some CNS stimulants are contraindicated in patients with marked agitation or anxiety.

Armodafinil has a moderate potential interaction with Psychosis.

Armodafinil may cause adverse psychiatric reactions. Caution should be exercised when using this agent in patients with a history of psychosis, depression, or mania. If psychiatric symptoms develop in association with armodafinil administration, consider discontinuing armodafinil. Close monitoring of psychiatric symptoms is recommended.

Armodafinil has a moderate potential interaction with Valvular Heart Disease.

Armodafinil may cause ECG changes, chest pain, or arrhythmia. Armodafinil should be used with caution in patients with cardiovascular complications. Armodafinil should not be used in patients with a history of left ventricular hypertrophy or in patients with mitral valve prolapse who have experienced the mitral valve prolapse syndrome when previously receiving CNS stimulants. It is recommended to monitor heart rate and blood pressure during treatment with armodafinil. Caution should be exercised when prescribing armodafinil to patients with known cardiovascular disease.