Drug Interaction Report

MONITOR: Coadministration with inducers of CYP450 2C9 may decrease the plasma concentrations of lesinurad. According to the manufacturer, administration of lesinurad with the potent CYP450 inducer rifampin (600 mg daily) decreased lesinurad peak plasma concentration (Cmax) and systemic exposure (AUC) by approximately 25% and 40%, respectively, compared to administration of lesinurad alone.

MANAGEMENT: The potential for diminished pharmacologic effects of lesinurad should be considered during coadministration with CYP450 2C9 inducers. Alternative treatments may be required if an interaction is suspected.

GENERALLY AVOID: Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.

MANAGEMENT: The combination of ethanol and barbiturates should be avoided.