Drug Interaction Report

According to the manufacturer, brivaracetam is a weak inhibitor of CYP450 2C19 in vitro and is not expected to cause significant inhibition of CYP450 2C19 in humans. No precaution is necessary when brivaracetam is coadministered with CYP450 2C19 substrates.

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of cilostazol. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. The extent and clinical significance are unknown. Moreover, pharmacokinetic alterations associated with interactions involving grapefruit juice are often subject to a high degree of interpatient variability.

MANAGEMENT: Until more information is available, the manufacturer recommends avoiding consumption of grapefruit juice during cilostazol therapy. Orange juice is not expected to interact with cilostazol.