Drug Interaction Report

GENERALLY AVOID: Coadministration with lasmiditan may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) and/or breast cancer resistance protein (BCRP) transporters. The proposed mechanism, based on in vitro data, involves decreased clearance due to inhibition of P-gp and BCRP by lasmiditan. The clinical relevance is unknown.

MANAGEMENT: Concomitant use of lasmiditan with drugs that are P-gp and/or BCRP substrates should be avoided when possible. If coadministration is required, patients should be carefully monitored for increased adverse reactions of these drugs and dosing adjusted as necessary.

Food reduces the oral absorption and bioavailability of mirabegron. According to the product labeling, administration of a 50 mg tablet with a high-fat meal decreased mirabegron peak plasma concentration (Cmax) and systemic exposure (AUC) by 45% and 17%, respectively, whereas administration with a low-fat meal decreased mirabegron Cmax and AUC by 75% and 51%, respectively. In phase 3 clinical studies demonstrating both safety and efficacy, mirabegron was administered without regards to food content and intake. Therefore, mirabegron can be taken with or without food at the recommended dosage.