Drug Interaction Report

MONITOR: Thalidomide can commonly cause drowsiness/sedation and may have additive effects with other drugs that cause central nervous system (CNS) depression.

MANAGEMENT: Caution is advised when thalidomide is used with other CNS depressants such as anticonvulsants, antihistamines, antidepressants, antipsychotics, anxiolytics, opioids, and sedatives/hypnotics. Patients should be advised to avoid hazardous activities requiring 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. Dosage reductions may be necessary. Thalidomide should preferably be administered at bedtime to reduce the impact of somnolence. Alcohol use is not recommended.

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.

ADJUST DOSING INTERVAL: Food may reduce the rate and extent of absorption of opicapone. When opicapone was administered following a moderate fat/moderate calorie meal, mean opicapone peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 62% and 31%, respectively, while the time to reach peak concentration (Tmax) was delayed by 4 hours.

MANAGEMENT: Patients should avoid eating 1 to 2 hours before and after taking opicapone.