Drug Interaction Report

MONITOR: Coadministration with potent inhibitors of uridine diphosphate glucuronosyltransferase (UGT) may increase the peak plasma concentration (Cmax) and systemic exposure (AUC) of dihydroartemisinin (DHA), an active metabolite of artesunate and substrate of UGT 1A9 or 2B7. Increased exposure to artesunate may increase the risk of adverse effects such as anemia, increased liver transaminases, thrombocytopenia, hyperbilirubinemia, acute renal failure, and leukocytosis.

MANAGEMENT: Monitoring for adverse reactions is recommended if artesunate is coadministered with potent UGT inhibitors. Dosage adjustments or alternative treatments may be required based on clinical response and tolerance.

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.