Drug Interaction Report

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

GENERALLY AVOID: Bremelanotide may slow gastric emptying and reduce the rate and extent of absorption of concomitantly administered oral medications. In clinical pharmacology studies, bremelanotide 1.75 mg given subcutaneously did not affect the absorption of most of the tested oral medications to any clinically relevant degree, including amlodipine, bupropion, celecoxib, ethinyl estradiol, furosemide, hydrochlorothiazide, lisinopril, losartan, metformin, metoprolol, norethindrone, phentermine, pseudoephedrine, sertraline, and venlafaxine. However, naltrexone peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by approximately 60% and 40%, respectively, relative to administration alone. Indomethacin Cmax and AUC decreased by approximately 35% and 20%, respectively, relative to administration alone.

MANAGEMENT: Patients should avoid the use of bremelanotide when taking concomitant oral medications that are dependent on threshold concentrations for efficacy (e.g., antibiotics). Patients should also consider avoiding bremelanotide when a quick onset of therapeutic effect is desired for concomitant oral medications (e.g., drugs for pain relief such as indomethacin).