Drug Interaction Report
3 potential interactions and/or warnings found for the following 2 drugs:
- trospium / xanomeline
- cinacalcet
Interactions between your drugs
cinacalcet xanomeline
Applies to: cinacalcet, trospium / xanomeline
MONITOR: Coadministration with potent inhibitors of CYP450 2D6 may increase the plasma concentrations as well as the pharmacologic and adverse effects of xanomeline. The proposed mechanism involves the inhibition of CYP450 2D6, an isoenzyme significantly responsible for the metabolic clearance of xanomeline. Furthermore, because CYP450 2D6 is genetically polymorphic, variations in xanomeline metabolism across populations may either increase or decrease the risk associated with this interaction. Increased exposure to xanomeline may potentiate the risk of adverse reactions such as nausea, dyspepsia, vomiting, abdominal pain, diarrhea and gastrointestinal reflux disease. However, data evaluating the interaction are not available.
MANAGEMENT: Caution and closer monitoring for adverse effects are recommended if xanomeline is used concurrently with potent CYP450 2D6 inhibitors.
References (1)
- (2024) "Product Information. Cobenfy (trospium-xanomeline)." Bristol-Myers Squibb
Drug and food interactions
trospium food
Applies to: trospium / xanomeline
ADJUST DOSING INTERVAL: Food may reduce the oral absorption and bioavailability of trospium chloride. According to the product labeling, administration of trospium chloride with a high fat meal reduced the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 70% to 80% compared to administration while fasting.
MANAGEMENT: To ensure maximal oral absorption, trospium chloride should be administered at least 1 hour before meals or on an empty stomach. If trospium chloride is administered as a combination with xanomeline, the manufacturer recommends administering the capsules at least 1 hour before a meal or at least 2 hours after a meal. Capsules should be taken whole.
References (5)
- (2012) "Product Information. Sanctura (trospium)." Odyssey Pharmaceuticals
- (2024) "Product Information. Cobenfy (trospium-xanomeline)." Bristol-Myers Squibb
- (2019) "Product Information. Trosec (trospium)." Oryx Pharmaceuticals Inc
- (2022) "Product Information. Regurin (trospium)." Mylan Healthcare Sdn. Bhd.
- (2023) "Product Information. Trospium Chloride (trospium)." Padagis
cinacalcet food
Applies to: cinacalcet
ADJUST DOSING INTERVAL: Food enhances the oral absorption and bioavailability of cinacalcet. According to the product labeling for cinacalcet, administration with a high-fat meal increased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of cinacalcet by 82% and 68%, respectively, compared to administration in the fasting state. The Cmax and AUC were increased 65% and 50%, respectively, when cinacalcet was administered with a low-fat meal compared to fasting.
MANAGEMENT: To ensure maximal oral absorption, cinacalcet should be administered with or immediately after a meal. The tablets should be taken whole and not divided or crushed.
References (1)
- (2004) "Product Information. Sensipar (cinacalcet)." Amgen USA
Therapeutic duplication warnings
No duplication warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
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