Drug Interaction Report

GENERALLY AVOID: Because pitolisant enhances the activity of histaminergic neurons in the brain, centrally acting histamine H1-receptor antagonists or medicines with H1-receptor antagonist properties (e.g., tri- and tetracyclic antidepressants) may impair the efficacy of pitolisant.

MANAGEMENT: According to the manufacturer, coadministration of pitolisant with centrally acting H1-receptor antagonists or tri- and tetracyclic antidepressants should be avoided.

GENERALLY AVOID: Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous. In addition, the potential for abuse may be increased with the combination. The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system. No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load. However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.

MANAGEMENT: Alcohol should generally be avoided during therapy with anticholinergic agents. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.