Interaction between Aprepitant and Naloxegol
Major
Metabolism
| ID | DDInter112 and DDInter1261 |
| Interaction | Coadministration with moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of naloxegol, which is primarily metabolized by the isoenzyme. Increased exposure to naloxegol may precipitate opioid withdrawal symptoms such as hyperhidrosis, lacrimation, rhinorrhea, chills, diarrhea, abdominal pain, anxiety, insomnia, irritability, restlessness, and yawning. |
| Management | Concomitant use of naloxegol with moderate CYP450 3A4 inhibitors should generally be avoided. If coadministration is required, the dosage of naloxegol should be reduced to 12.5 mg once daily and the patient closely monitored for opioid withdrawal symptoms. |
| References | |
| Alternative for Aprepitant |
A04A
|
| Alternative for Naloxegol |
A06A
More
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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.