Interaction between Tapentadol and Safinamide
Major
Synergy
| ID | DDInter1746 and DDInter1631 |
| Interaction | Monoamine oxidase inhibitors (MAOIs) may potentiate the noradrenergic and serotonergic activities of tapentadol. The mechanism is an additive pharmacodynamic effect resulting from MAOI inhibition of norepinephrine and serotonin metabolism and tapentadol inhibition of their reuptake. Theoretically, coadministration may increase the risk of adverse cardiovascular effects such as hypotension, hypertension, and arrhythmias due to elevated norepinephrine levels. In addition, an increased risk of seizure may occur due to additive lowering of seizure threshold. The interaction may also cause serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea. |
| Management | The use of tapentadol in patients currently receiving or within 14 days of receiving a monoamine oxidase inhibitor (MAOI) is considered contraindicated. |
| References | |
| Alternative for Tapentadol |
N02A
More
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| Alternative for Safinamide |
N04B
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Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.