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Drug Interaction Report

1 drug interaction and 8 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

osilodrostat trofinetide

Applies to: osilodrostat, trofinetide

Trofinetide may increase the blood levels of osilodrostat in some patients.

This may increase the risk and/or severity of serious and potentially life-threatening side effects such as:

  • hypocortisolism (low cortisol levels in the blood)
  • QT prolongation (a heart condition that can lead to irregular heart rhythm)
  • elevated levels of male hormones
  • high blood pressure
  • fluid retention
  • swelling
  • hypokalemia (low potassium levels in the blood, which in severe cases can lead to muscle weakness, paralysis, breathing and swallowing difficulties (due to muscle paralysis), and irregular heart rhythm)

Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications.

Let your doctor know if you experience:

  • nausea
  • vomiting
  • abdominal pain
  • loss of appetite
  • fatigue
  • confusion
  • dizziness
  • lightheadedness
  • fainting
  • muscle weakness
  • muscle cramps
  • numbness or tingling
  • rapid or irregular heart beat
  • chest pain
  • swelling in the legs or feet

These may be symptoms of hypokalemia or other excessive effects of osilodrostat.

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

8 potential interactionsApplies to: 8 conditions, including Heart Failure, Arrhythmia, Hypokalemia, Adrenal Insufficiency, and Liver Disease.

Adrenal Insufficiency

Moderate:

osilodrostat

Osilodrostat has a moderate potential interaction with Adrenal Insufficiency.

Osilodrostat lowers cortisol levels and can lead to hypocortisolism and sometimes life-threatening adrenal insufficiency. Patients should be evaluated for precipitating causes of hypocortisolism. Serum/plasma cortisol, 24-hour urine free cortisol, and patient's signs/symptoms should be monitored periodically during treatment. Osilodrostat should be decreased or temporarily discontinued if urine free cortisol levels fall below the target range, there is a rapid decrease in cortisol levels, and/or patients report hypocortisolism symptoms. Therapy should be stopped and exogenous glucocorticoid replacement therapy should be administered if serum/plasma cortisol levels are below the target range and patients have symptoms of adrenal insufficiency. Osilodrostat should be restarted at a lower dose when urine free cortisol and serum/plasma cortisol levels are within the target range, and/or patient symptoms have resolved.

Arrhythmia

Moderate:

osilodrostat

Osilodrostat has a moderate potential interaction with Arrhythmia.

The use of osilodrostat is associated with a dose-dependent QT interval prolongation, which may cause cardiac arrhythmias. It is recommended to perform an ECG to obtain a baseline QTc interval measurement before starting therapy and to monitor for an effect on the QTc interval thereafter. Temporary discontinuation of osilodrostat should be considered in the case of an increase in QTc interval greater than 480 milliseconds. Hypokalemia and hypomagnesemia should be corrected before initiating treatment and monitored regularly during treatment. Electrolyte abnormalities should be corrected if indicated. Care should be exercised when using this agent in patients with risk factors for QT prolongation and more frequent ECG monitoring should be considered.

Electrolyte Abnormalities

Moderate:

osilodrostat

Osilodrostat has a moderate potential interaction with Electrolyte Abnormalities.

The use of osilodrostat is associated with a dose-dependent QT interval prolongation, which may cause cardiac arrhythmias. It is recommended to perform an ECG to obtain a baseline QTc interval measurement before starting therapy and to monitor for an effect on the QTc interval thereafter. Temporary discontinuation of osilodrostat should be considered in the case of an increase in QTc interval greater than 480 milliseconds. Hypokalemia and hypomagnesemia should be corrected before initiating treatment and monitored regularly during treatment. Electrolyte abnormalities should be corrected if indicated. Care should be exercised when using this agent in patients with risk factors for QT prolongation and more frequent ECG monitoring should be considered.

Heart Failure

Moderate:

osilodrostat

Osilodrostat has a moderate potential interaction with Heart Failure.

The use of osilodrostat is associated with a dose-dependent QT interval prolongation, which may cause cardiac arrhythmias. It is recommended to perform an ECG to obtain a baseline QTc interval measurement before starting therapy and to monitor for an effect on the QTc interval thereafter. Temporary discontinuation of osilodrostat should be considered in the case of an increase in QTc interval greater than 480 milliseconds. Hypokalemia and hypomagnesemia should be corrected before initiating treatment and monitored regularly during treatment. Electrolyte abnormalities should be corrected if indicated. Care should be exercised when using this agent in patients with risk factors for QT prolongation and more frequent ECG monitoring should be considered.

Hypokalemia

Moderate:

osilodrostat

Osilodrostat has a moderate potential interaction with Hypokalemia.

The use of osilodrostat is associated with a dose-dependent QT interval prolongation, which may cause cardiac arrhythmias. It is recommended to perform an ECG to obtain a baseline QTc interval measurement before starting therapy and to monitor for an effect on the QTc interval thereafter. Temporary discontinuation of osilodrostat should be considered in the case of an increase in QTc interval greater than 480 milliseconds. Hypokalemia and hypomagnesemia should be corrected before initiating treatment and monitored regularly during treatment. Electrolyte abnormalities should be corrected if indicated. Care should be exercised when using this agent in patients with risk factors for QT prolongation and more frequent ECG monitoring should be considered.

Liver Disease

Moderate:

osilodrostat

Osilodrostat has a moderate potential interaction with Liver Disease.

Dosage adjustment of osilodrostat is required for patients with moderate to severe liver dysfunction. The recommended starting dose for patients with moderate liver dysfunction is 1 mg orally twice a day, and for patients with severe liver dysfunction is 1 mg orally once a day in the evening. No dose adjustment is required in patients with mild liver dysfunction. More frequent monitoring of adrenal function may be needed during dose titration in all patients with liver dysfunction.

Magnesium Imbalance

Moderate:

osilodrostat

Osilodrostat has a moderate potential interaction with Magnesium Imbalance.

The use of osilodrostat is associated with a dose-dependent QT interval prolongation, which may cause cardiac arrhythmias. It is recommended to perform an ECG to obtain a baseline QTc interval measurement before starting therapy and to monitor for an effect on the QTc interval thereafter. Temporary discontinuation of osilodrostat should be considered in the case of an increase in QTc interval greater than 480 milliseconds. Hypokalemia and hypomagnesemia should be corrected before initiating treatment and monitored regularly during treatment. Electrolyte abnormalities should be corrected if indicated. Care should be exercised when using this agent in patients with risk factors for QT prolongation and more frequent ECG monitoring should be considered.

Renal Dysfunction

Moderate:

osilodrostat

Osilodrostat has a moderate potential interaction with Renal Dysfunction.

No dosage adjustment of osilodrostat is required for patients with impaired renal function. However, in patients with moderate to severe renal dysfunction, urinary free cortisol (UFC) levels should be interpreted with caution due to reduced UFC excretion.

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.