Drug Interaction Report

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of daridorexant, which is primarily metabolized by the isoenzyme. According to the manufacturer, concomitant use of a mild CYP450 3A4 inhibitor, ranitidine, increased daridorexant peak plasma concentration (Cmax) and systemic exposure (AUC) by 1.1- and 1.5-fold, respectively. Increased exposure to daridorexant may increase the risk of adverse reactions such as central nervous system (CNS) depression, sleep paralysis, hallucinations, complex sleep behaviors, worsening of depression or suicidal ideation, or headache.

MANAGEMENT: Caution and close monitoring for the development of adverse effects are advisable during coadministration of daridorexant with CYP450 3A4 inhibitors. Additional caution is advised if the CYP450 3A4 inhibitor causes CNS depression (e.g., rupatadine) as this effect may be increased.

Do not consume grapefruit, grapefruit juice, or any supplements that contain grapefruit extract during treatment with daridorexant unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of daridorexant. This may increase the risk of side effects such as somnolence, fatigue, abnormal sleep behaviors, worsening of depression or suicidal thoughts, or headache. You should avoid the use of alcohol while being treated with daridorexant. Alcohol can increase the nervous system side effects of daridorexant such as dizziness, drowsiness, and reduced coordination. Some people may also experience complex sleep behaviors such as sleepwalking, sleep driving, preparing and eating food or doing other activities while not fully awake that you may not remember the next morning. Talk to your doctor if you have any questions or concerns. 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.

Consumer information for this interaction is not currently available.

MONITOR: Smoking and alcohol consumption during therapy with vadadustat may increase the risk of gastrointestinal erosions. Serious erosions, including gastrointestinal bleeding and the need for red blood cell transfusions, have been reported during vadadustat clinical trials. Patients with a history of gastrointestinal erosion, peptic ulcer disease, and current tobacco smokers and alcohol drinkers may be at higher risk of gastrointestinal injury.

MANAGEMENT: Caution is advised if vadadustat is prescribed to current tobacco smokers or alcohol drinkers. Patients should be advised to contact their physician if they develop potential signs and symptoms of gastrointestinal injury such as abdominal pain, hematemesis, trouble swallowing, chest or throat pain, and/or black, tarry stools.