Drug Interaction Report

MONITOR: Theoretically, dopamine agonists (e.g., antiparkinson agents, ergot derivatives) and antagonists (e.g., neuroleptics, antiemetics) may affect imaging results obtained using ioflupane I-123, which binds to the dopamine transporter. However, their concomitant use has not been extensively studied. Whether discontinuation of these drugs prior to ioflupane I-123 administration may help to minimize potential interference is unknown.

MANAGEMENT: Clinicians using ioflupane I-123 should be aware of possible diagnostic interference by dopamine agonists and antagonists.

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

Administration with food may increase the bioavailability of paliperidone from the extended release tablets. In healthy ambulatory subjects, administration of a 12 mg paliperidone extended release tablet with a standard high-fat/high-caloric meal resulted in 60% and 54% increases, respectively, in the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of paliperidone compared to administration under fasting conditions. The clinical significance of these changes is unknown.

MANAGEMENT: Patients receiving paliperidone should be advised to avoid the consumption of alcohol. Since clinical trials establishing the safety and efficacy of paliperidone were carried out without regard to the timing of meals, presumably paliperidone may be administered with or without food.