Interaction between
Droperidol
and
Fostemsavir
Major
Synergy
Basic Information
| ID | DDInter603 and DDInter786 |
| Interaction | The use of droperidol has been associated with QT interval prolongation, torsade de pointes and other serious arrhythmias, and sudden death. The concurrent administration of agents that can produce hypokalemia and/or hypomagnesemia (e.g., potassium-wasting diuretics, amphotericin B, cation exchange resins), drugs known to increase the QT interval (e.g., phenothiazines, tricyclic antidepressants, antiarrhythmic agents, etc.), certain other drugs (benzodiazepines, volatile anesthetics, intravenous opiates), or alcohol abuse may increase the risk of prolonged QT syndrome. |
| Management | The manufacturer recommends extreme caution if droperidol must be given concomitantly with these agents. The dosage of droperidol should be individualized and titrated to the desired effect. Routine vital sign and ECG monitoring is recommended. When droperidol is used in combination with other drugs that cause CNS and/or respiratory depression, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. |
| References | [1] Canadian Pharmacists Association "e-CPS. Available from: URL: http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink." [2] EMA. European Medicines Agency. European Union "EMA - List of medicines under additional monitoring. Available from: URL: http://www.ema.europa.eu/ema/index.jsp?curl=pages/regulation/document_listing/document_listing_000366.jsp&mid=WC0b01ac058067c852" ([2013 - ]): [3] "Product Information. Inapsine (droperidol)." Janssen Pharmaceutica, Titusville, NJ. [4] Glassman AH, Bigger JT Jr "Antipsychotic drugs: prolonged QTc interval, torsade de pointes, and sudden death." Am J Psychiatry 158 (2001): 1774-82 [5] Cerner Multum, Inc. "Australian Product Information." O 0 [6] Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0 [7] Cerner Multum, Inc. "Australian Product Information." O 0 [8] Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0 [9] Lemma GL, Desta Z, Jones DR, Gorski JC, Hall SD "Droperidol is predominantly metabolized by human CYP3A enzymes." Clin Pharmacol Ther 73 (2003): 16 [10] "Product Information. Droperidol (droperidol)." Abbott Pharmaceutical, Abbott Park, IL. [11] Agencia Española de Medicamentos y Productos Sanitarios Healthcare "Centro de información online de medicamentos de la AEMPS - CIMA. Available from: URL: https://cima.aemps.es/cima/publico/home.html." ([2018]): [12] Cerner Multum, Inc "ANVISA Bulário Eletrônico. Available from: URL: http://www.anvisa.gov.br/datavisa/fila_bula/index.asp." O 0 (2015): [13] "Product Information. Inapsine (droperidol)." Janssen Pharmaceutica, Titusville, NJ. [14] "Product Information. Kaletra (lopinavir-ritonavir)" Abbott Pharmaceutical, Abbott Park, IL. [15] "Product Information. Norvir (ritonavir)." Abbott Pharmaceutical, Abbott Park, IL. |
| Alternative for Droperidol |
N05A
|
| Alternative for Fostemsavir |
J05A
|
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.