Drug Interaction Report

MONITOR: Treatment with metreleptin, a recombinant analog of human leptin, may affect the pharmacokinetics of drugs that are primarily metabolized by CYP450 isoenzymes. In leptin-deficient obese mice, administration of leptin has been shown to alter the hepatic levels of some CYP450 isoenzymes.

MANAGEMENT: Caution is advised when metreleptin is prescribed to patients receiving drugs with a narrow therapeutic index that are substrates of CYP450 isoenzymes, such as macrolide immunosuppressants, oral contraceptives, cyclosporine, theophylline, and warfarin. Clinical and laboratory monitoring are recommended following the initiation, discontinuation or change of dosage of metreleptin, and the individual dosage of the concomitant agents adjusted as needed.

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.

MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.