Drug Interaction Report

MONITOR: Coadministration of lasmiditan and agents that lower heart rate may increase the risk of bradycardia. In clinical trials, lasmiditan was associated with heart rate decreases of 5 to 10 beats per minute (bpm) while placebo was associated with decreases of 2 to 5 bpm. In a drug interaction study, a single 200 mg dose of lasmiditan led to an additional heart rate decrease of 5 bpm when given with propranolol.

MANAGEMENT: Caution is advised during coadministration of lasmiditan and agents that lower heart rate if the estimated decrease in heart rate may present a clinical risk. Consider monitoring heart rate in patients for whom the estimated decrease in heart rate may not be tolerated.

ADJUST DOSING INTERVAL: Administration of atazanavir with food enhances oral bioavailability and reduces pharmacokinetic variability. According to the manufacturer, administration with a light meal increased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of a single 400 mg dose of atazanavir by 57% and 70%, respectively, relative to the fasting state. Administration with a high-fat meal resulted in a mean increase of 35% in atazanavir AUC and no change in Cmax compared to fasting. The coefficient of variation of AUC and Cmax decreased by approximately one-half when given with either a light or high-fat meal compared to the fasting state.

MANAGEMENT: To ensure maximal oral absorption, atazanavir should be administered with or immediately after a meal.