Drug Interaction Report

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of naloxegol, which is primarily metabolized by the isoenzyme. When a single 25 mg dose of naloxegol was administered during multiple dosing of 600 mg once daily rifampin, a potent CYP450 3A4 inducer, naloxegol peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 76% and 89%, respectively. Simulations using physiologically based pharmacokinetic modeling suggest that when a single 25 mg dose of naloxegol is administered with 400 mg once daily efavirenz, a moderate CYP450 3A4 inducer, naloxegol exposures are similar to those after a 12.5 mg dose of naloxegol alone.

MANAGEMENT: The potential for diminished therapeutic effects of naloxegol should be considered when prescribed with inducers of CYP450 3A4. Pharmacologic effects of naloxegol should be monitored more closely whenever an inducer is added to or withdrawn from therapy, and alternative treatment considered if an interaction is suspected.

Do not consume grapefruit or grapefruit juice during treatment with naloxegol. Grapefruit juice can significantly increase the blood levels of naloxegol. You may be more likely to experience side effects and withdrawal symptoms such as sweating, tearing, runny nose, chills, diarrhea, abdominal pain, anxiety, insomnia, irritability, restlessness, and yawning. Taking naloxegol with food can also increase its absorption into the blood stream. Therefore, you should take it on an empty stomach at least 1 hour before or 2 hours after a meal. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.