Drug Interaction Report

Narcotics and medications that are used to treat insomnia or anxiety may increase the risk and/or severity of nervous system and psychiatric side effects that have been associated with the use of ropeginterferon alfa-2b. These adverse reactions may occur with or without a history of psychiatric illness and may include mental health problems and behaviors such as depression, suicidal thoughts and tendencies, irritability, restlessness, agitation, aggression, confusion, and bipolar disorder. 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. You should stop using ropeginterferon alfa-2b immediately and seek medical attention if you experience mental health symptoms or any unusual changes in mood or behavior. 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.

Do not consume grapefruit or grapefruit juice during treatment with levomethadyl acetate unless directed otherwise by your doctor. Grapefruit juice may increase the blood levels of levomethadyl acetate. This can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). You should also avoid alcohol during treatment, as it may add to the central nervous system effects of levomethadyl acetate and increase the risk of serious side effects such as respiratory depression, low blood pressure, fainting, coma, and even death. Do not drive, operate machinery, or perform other hazardous activities until you know how the medication affects you. Talk to your doctor if you have any questions or concerns. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment. 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.