Drug Interaction Report
3 potential interactions and/or warnings found for the following 2 drugs:
- cenobamate
- Piqray (alpelisib)
Interactions between your drugs
alpelisib cenobamate
Applies to: Piqray (alpelisib), cenobamate
MONITOR: Coadministration of alpelisib with inducers of CYP450 3A4 may reduce the plasma concentrations of alpelisib. The proposed mechanism, based on in vitro data, is increased clearance due to induction of CYP450 3A4, which is one of the routes of metabolism of alpelisib. According to the manufacturer, therapeutic efficacy of alpelisib may be reduced in the presence of potent CYP450 3A4 inducers; however, clinical data are lacking. Data are not available for mild to moderate CYP450 3A4 inducers.
MANAGEMENT: Caution is recommended when alpelisib is used with CYP450 3A4 inducers. Pharmacologic effects of alpelisib should be monitored more closely whenever the inducer is added to or withdrawn from therapy.
References (1)
- (2019) "Product Information. Piqray (alpelisib)." Novartis Pharmaceuticals
Drug and food/lifestyle interactions
alpelisib food/lifestyle
Applies to: Piqray (alpelisib)
ADJUST DOSING INTERVAL: Food significantly enhances the oral absorption and bioavailability of alpelisib. When administered with a high-fat high-calorie meal (985 calories with 58.1 g of fat) or a low-fat low-calorie meal (334 calories with 8.7 g of fat) the AUC and Cmax of a single dose of alpelisib was increased by 73% and 84% and 77% and 145%, respectively. There were no clinically significant differences in alpelisib AUC between the two types of meals. In addition, food appears to have a more pronounced effect on the solubility of alpelisib than gastric pH. When coadministered with a single 300 mg dose of alpelisib, ranitidine decreased the absorption and overall exposure of alpelisib. Following administration of ranitidine with a low-fat low-calorie meal, the mean AUC and Cmax of alpelisib was decreased by 21% and 36%, respectively. Administration of ranitidine under fasting conditions reduced the mean AUC and Cmax of alpelisib by 30% and 51%, respectively.
MANAGEMENT: To ensure maximal oral absorption, alpelisib should be administered with a meal.
References (1)
- (2019) "Product Information. Piqray (alpelisib)." Novartis Pharmaceuticals
cenobamate food/lifestyle
Applies to: cenobamate
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.
References (4)
- Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
- Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
- (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
Therapeutic duplication warnings
No duplication warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
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