Drug Interaction Report
2 potential interactions and/or warnings found for the following 2 drugs:
- teriflunomide
- Vivarin (caffeine)
Interactions between your drugs
caffeine teriflunomide
Applies to: Vivarin (caffeine), teriflunomide
MONITOR: Coadministration with teriflunomide may decrease the plasma concentrations and therapeutic effects of drugs that are substrates of CYP450 1A2. The proposed mechanism is increased clearance due to teriflunomide-mediated induction of CYP450 1A2. Multiple doses of teriflunomide decreased mean Cmax and AUC of caffeine, a known CYP450 1A2 substrate, by 18% and 55%, respectively.
MANAGEMENT: Caution is advised if teriflunomide is used concomitantly with drugs that are substrates of CYP450 1A2. Dosage adjustments as well as clinical and laboratory monitoring should be considered whenever teriflunomide is added to or withdrawn from therapy with these drugs.
References (3)
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
- (2012) "Product Information. Aubagio (teriflunomide)." Genzyme Corporation
Drug and food interactions
caffeine food
Applies to: Vivarin (caffeine)
The effect of grapefruit juice on the pharmacologic activity of caffeine is controversial. One report suggests that grapefruit juice increases the effect of caffeine. The proposed mechanism is inhibition of cytochrome P-450 metabolism of caffeine. However, a well-conducted pharmacokinetic/pharmacodynamic study did not demonstrate this effect. The clinical significance of this potential interaction is unknown.
References (2)
- (1995) "Grapefruit juice interactions with drugs." Med Lett Drugs Ther, 37, p. 73-4
- Maish WA, Hampton EM, Whitsett TL, Shepard JD, Lovallo WR (1996) "Influence of grapefruit juice on caffeine pharmacokinetics and pharmacodynamics." Pharmacotherapy, 16, p. 1046-52
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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