Drug Interaction Report

Coadministration with prasugrel may alter the metabolism of drugs that are substrates of CYP450 2B6. Prasugrel is a weak inhibitor of the isoenzyme. In healthy subjects, prasugrel decreased systemic exposure to hydroxybupropion, a CYP450 2B6-mediated metabolite of bupropion, by 23%. This change is not considered clinically significant. Therefore, prasugrel is not anticipated to have a significant effect on the pharmacokinetics of drugs that are primarily metabolized by CYP450 2B6 such as cyclophosphamide, efavirenz, halothane, nevirapine, propofol, selegiline, and tamoxifen.

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

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.