Drug Interaction Report

MONITOR: Coadministration with lorcaserin may increase the plasma concentrations of drugs that are primarily metabolized by CYP450 2D6. The mechanism is decreased clearance due to inhibition of CYP450 2D6 activity by lorcaserin. In a study consisting of 21 CYP450 2D6 extensive metabolizers, administration of the probe substrate dextromethorphan in combination with lorcaserin 10 mg twice daily for 4 days increased dextromethorphan peak concentrations (Cmax) by approximately 76% and systemic exposure (AUC) by approximately 2-fold.

MANAGEMENT: Caution is advised if lorcaserin is prescribed concomitantly with medications that undergo metabolism by CYP450 2D6, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever lorcaserin is added to or withdrawn from therapy.

Food does not appear to significantly affect the absorption and oral bioavailability of lurasidone. In twelve adult volunteers (6 men and 6 women), administration of a single 10 mg oral dose of lorcaserin following a high-fat (approximately 50% of total caloric content of the meal) and high-calorie (approximately 800 to 1000 calories) meal resulted in less than 10% increases in lorcaserin peak plasma concentration (Cmax) and systemic exposure (AUC) compared to administration in the fasted state. The time to reach peak concentration (Tmax) was delayed by approximately 1 hour in the fed state. Lorcaserin may be administered with or without food.