Drug Interaction Report
3 potential interactions and/or warnings found for the following 2 drugs:
- avatrombopag
- trospium / xanomeline
Interactions between your drugs
avatrombopag xanomeline
Applies to: avatrombopag, trospium / xanomeline
MONITOR: Xanomeline may increase the concentration of sensitive oral CYP450 3A4 substrates and/or narrow therapeutic index (NTI) oral P-glycoprotein (P-gp) substrates. In vitro data suggest that xanomeline may transiently inhibit CYP450 3A4 and P-gp locally in the intestine after dosing. Xanomeline does not appear to inhibit CYP450 3A4 and/or P-gp systemically. Clinical data evaluating this interaction are not available.
MANAGEMENT: Caution and clinical monitoring are advised if xanomeline is used in combination with an orally administered CYP450 3A4 sensitive substrate and/or NTI P-gp substrate for which a small change in substrate plasma concentration could lead to serious toxicities. The labeling of the substrate may be consulted for specific monitoring and dose adjustment recommendations should adverse reactions result from this combination.
References (1)
- (2024) "Product Information. Cobenfy (trospium-xanomeline)." Bristol-Myers Squibb
Drug and food interactions
trospium food
Applies to: trospium / xanomeline
ADJUST DOSING INTERVAL: Food may reduce the oral absorption and bioavailability of trospium chloride. According to the product labeling, administration of trospium chloride with a high fat meal reduced the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 70% to 80% compared to administration while fasting.
MANAGEMENT: To ensure maximal oral absorption, trospium chloride should be administered at least 1 hour before meals or on an empty stomach. If trospium chloride is administered as a combination with xanomeline, the manufacturer recommends administering the capsules at least 1 hour before a meal or at least 2 hours after a meal. Capsules should be taken whole.
References (5)
- (2012) "Product Information. Sanctura (trospium)." Odyssey Pharmaceuticals
- (2024) "Product Information. Cobenfy (trospium-xanomeline)." Bristol-Myers Squibb
- (2019) "Product Information. Trosec (trospium)." Oryx Pharmaceuticals Inc
- (2022) "Product Information. Regurin (trospium)." Mylan Healthcare Sdn. Bhd.
- (2023) "Product Information. Trospium Chloride (trospium)." Padagis
avatrombopag food
Applies to: avatrombopag
ADJUST DOSING INTERVAL: Food reduces the variability in oral absorption and bioavailability of avatrombopag. According to the product labeling, avatrombopag peak plasma concentration (Cmax) and systemic exposure (AUC) were not affected when administered with either a low-fat (500 calories; 3 g fat, 15 g proteins, 108 g carbohydrates) or high-fat (918 calories; 59 g fat, 39 g proteins, 59 g carbohydrates) meal. However, the variability of avatrombopag exposure was reduced by 40% to 60% with food, and the time to reach Cmax was delayed by 0 to 2 hours relative to the fasted state.
MANAGEMENT: To ensure consistent absorption and plasma drug levels, avatrombopag should be taken with food.
References (1)
- (2018) "Product Information. Doptelet (avatrombopag)." Dova Pharmaceuticals
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.
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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