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Drug Interaction Report

1 drug interaction and 9 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

pitolisant trofinetide

Applies to: pitolisant, trofinetide

Trofinetide may increase the blood levels and effects of pitolisant.

Talk to your doctor if you have any questions or concerns.

You may need more frequent monitoring to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects.

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.

Food/lifestyle interactions

No alcohol/food interactions were found with the drugs in your list. However, this does not necessarily mean no food interactions exist. Always consult your healthcare provider.

Disease interactions

9 potential interactionsApplies to: 7 conditions, including Depression, Arrhythmia, Hypokalemia, Psychosis, and Liver Disease.

Arrhythmia

Moderate:

pitolisant

Pitolisant has a moderate potential interaction with Arrhythmia.

Pitolisant prolongs the QT interval. The use of pitolisant should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong the QT interval. The use of pitolisant should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and the presence of congenital prolongation of the QT interval. The risk of QT prolongation may be greater in patients with hepatic or renal impairment due to higher concentrations of pitolisant. It is recommended to monitor patients with hepatic or renal impairment for increased QTc. Exercise care when using this agent in patients with these conditions.

Depression

Major:

pitolisant

Pitolisant has a major potential interaction with Depression.

The use of CNS stimulants can cause psychotic symptoms, suicidal ideation, and aggression, and can exacerbate symptoms of behavior disturbance and thought disorder; CNS stimulants may induce a manic or mixed episode in patients with bipolar disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders. All patients (particularly those with psychotic or bipolar disorders) should be monitored closely, especially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. Prior to initiating therapy, all patients should be screened for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or family history of suicide, bipolar disease, or depression). If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. Some CNS stimulants are contraindicated in patients with marked agitation or anxiety.

Hypokalemia

Moderate:

pitolisant

Pitolisant has a moderate potential interaction with Hypokalemia.

Pitolisant prolongs the QT interval. The use of pitolisant should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong the QT interval. The use of pitolisant should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and the presence of congenital prolongation of the QT interval. The risk of QT prolongation may be greater in patients with hepatic or renal impairment due to higher concentrations of pitolisant. It is recommended to monitor patients with hepatic or renal impairment for increased QTc. Exercise care when using this agent in patients with these conditions.

Liver Disease

Major:

pitolisant

Pitolisant has a major potential interaction with Liver Disease.

Pitolisant is contraindicated in patients with severe hepatic impairment. Pitolisant is extensively metabolized by the liver. Care should be exercised when using pitolisant in patients with moderate hepatic impairment. It is recommended to monitor patients with mild and moderate hepatic impairment and to adjust the dosage of pitolisant in patients with moderate hepatic impairment as appropriate. No dosage adjustment is recommended in patients with mild hepatic impairment.

Moderate:

pitolisant

Pitolisant has a moderate potential interaction with Liver Disease.

Pitolisant prolongs the QT interval. The use of pitolisant should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong the QT interval. The use of pitolisant should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and the presence of congenital prolongation of the QT interval. The risk of QT prolongation may be greater in patients with hepatic or renal impairment due to higher concentrations of pitolisant. It is recommended to monitor patients with hepatic or renal impairment for increased QTc. Exercise care when using this agent in patients with these conditions.

Magnesium Imbalance

Moderate:

pitolisant

Pitolisant has a moderate potential interaction with Magnesium Imbalance.

Pitolisant prolongs the QT interval. The use of pitolisant should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong the QT interval. The use of pitolisant should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and the presence of congenital prolongation of the QT interval. The risk of QT prolongation may be greater in patients with hepatic or renal impairment due to higher concentrations of pitolisant. It is recommended to monitor patients with hepatic or renal impairment for increased QTc. Exercise care when using this agent in patients with these conditions.

Psychosis

Major:

pitolisant

Pitolisant has a major potential interaction with Psychosis.

The use of CNS stimulants can cause psychotic symptoms, suicidal ideation, and aggression, and can exacerbate symptoms of behavior disturbance and thought disorder; CNS stimulants may induce a manic or mixed episode in patients with bipolar disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders. All patients (particularly those with psychotic or bipolar disorders) should be monitored closely, especially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. Prior to initiating therapy, all patients should be screened for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or family history of suicide, bipolar disease, or depression). If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. Some CNS stimulants are contraindicated in patients with marked agitation or anxiety.

Renal Dysfunction

Moderate:

pitolisant

Pitolisant has a moderate potential interaction with Renal Dysfunction.

The pharmacokinetics of pitolisant in patients with end-stage renal disease (ESRD) (eGFR of <15 mL/minute/1.73 m2) is unknown. Pitolisant is not recommended in patients with ESRD. It is recommended to adjust the dosage of pitolisant when using this agent in patients with moderate (eGFR 30 to 59 mL/minute/1.73 m2) and severe (eGFR 15 to 29 mL/minute/1.73 m2) renal impairment.

Moderate:

pitolisant

Pitolisant has a moderate potential interaction with Renal Dysfunction.

Pitolisant prolongs the QT interval. The use of pitolisant should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong the QT interval. The use of pitolisant should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and the presence of congenital prolongation of the QT interval. The risk of QT prolongation may be greater in patients with hepatic or renal impairment due to higher concentrations of pitolisant. It is recommended to monitor patients with hepatic or renal impairment for increased QTc. Exercise care when using this agent in patients with these conditions.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.