Drug Interaction Report
2 potential interactions and/or warnings found for the following 2 drugs:
- dehydroepiandrosterone
- Klonopin Wafer (clonazepam)
Interactions between your drugs
clonazePAM dehydroepiandrosterone (prasterone)
Applies to: Klonopin Wafer (clonazepam), dehydroepiandrosterone
Dehydroepiandrosterone (prasterone) may increase serum concentrations of some benzodiazepines. The suggested mechanism is inhibition of the CYP450 3A4 enzyme responsible for metabolism of these drugs; however, evidence that dehydroepiandrosterone (prasterone) can inhibit CYP450 3A4 is conflicting. Patients should be observed for adverse effects and dosage adjustments should be made if indicated.
References (2)
- Frye RF, Kroboth PD, Folan MM, et al. (2000) "Effect of DHEA on CYP3A4-mediated metabolism of triazolam." Clin Pharmacol Ther, 67, p. 109
- Kohalmy K, Tamasi V, Kobori L, et al. (2007) "Dehydroepiandrosterone induces human CYP2B6 through the constitutive androstane receptor." Drug Metab Dispos, 35, p. 1495-501
Drug and food interactions
clonazePAM food
Applies to: Klonopin Wafer (clonazepam)
GENERALLY AVOID: Acute ethanol ingestion may potentiate the CNS effects of many benzodiazepines. Tolerance may develop with chronic ethanol use. The mechanism may be decreased clearance of the benzodiazepines because of CYP450 hepatic enzyme inhibition. Also, it has been suggested that the cognitive deficits induced by benzodiazepines may be increased in patients who chronically consume large amounts of alcohol.
MANAGEMENT: Patients should be advised to avoid alcohol during benzodiazepine therapy.
References (7)
- MacLeod SM, Giles HG, Patzalek G, Thiessen JJ, Sellers EM (1977) "Diazepam actions and plasma concentrations following ethanol ingestion." Eur J Clin Pharmacol, 11, p. 345-9
- Whiting B, Lawrence JR, Skellern GG, Meier J (1979) "Effect of acute alcohol intoxication on the metabolism and plasma kinetics of chlordiazepoxide." Br J Clin Pharmacol, 7, p. 95-100
- Divoll M, Greenblatt DJ, Lacasse Y, Shader RI (1981) "Benzodiazepine overdosage: plasma concentrations and clinical outcome." Psychopharmacology (Berl), 73, p. 381-3
- Juhl RP, Van Thiel DH, Dittert LW, Smith RB (1984) "Alprazolam pharmacokinetics in alcoholic liver disease." J Clin Pharmacol, 24, p. 113-9
- Ochs HR, Greenblatt DJ, Arendt RM, Hubbel W, Shader RI (1984) "Pharmacokinetic noninteraction of triazolam and ethanol." J Clin Psychopharmacol, 4, p. 106-7
- Staak M, Raff G, Nusser W (1979) "Pharmacopsychological investigations concerning the combined effects of dipotassium clorazepate and ethanol." Int J Clin Pharmacol Biopharm, 17, p. 205-12
- Nichols JM, Martin F, Kirkby KC (1993) "A comparison of the effect of lorazepam on memory in heavy and low social drinkers." Psychopharmacology (Berl), 112, p. 475-82
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
| 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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