Naldemedineinteractions

Table 3 includes drugs with clinically important drug interactions with SYMPROIC and instructions for preventing or managing the interaction.

Table 3: Clinically Relevant Interactions Affecting Naldemedine When Co-Administered with Other Drugs Strong CYP3A Inducers (e.g., rifampin, carbamazepine, phenytoin, St. John's Wort) Clinical Impact Significant decrease in plasma naldemedine concentrations, which may reduce efficacy Intervention Avoid use of SYMPROIC with strong CYP3A inducers. Other Opioid Antagonists Clinical Impact Potential for additive effect of opioid receptor antagonism and increased risk of opioid withdrawal. Intervention Avoid use of SYMPROIC with another opioid antagonist. Moderate (e.g., fluconazole, atazanavir, aprepitant, diltiazem, erythromycin) and Strong (e.g., itraconazole, ketoconazole, clarithromycin, ritonavir, saquinavir) CYP3A Inhibitors Clinical Impact Increase in plasma naldemedine concentrations Intervention Monitor for potential naldemedine-related adverse reactions. P-glycoprotein (P-gp) Inhibitors (e.g., amiodarone, captopril, cyclosporine, quercetin, quinidine, verapamil) Clinical Impact Increase in plasma naldemedine concentrations Intervention Monitor for potential naldemedine-related adverse reactions. Strong CYP3A inducers (e.g., rifampin): Decreased naldemedine concentrations; avoid concomitant use Other opioid antagonists: Potential for additive effect and increased risk of opioid withdrawal; avoid concomitant use Moderate (e.g., fluconazole) and strong (e.g., itraconazole) CYP3A4 inhibitors: Increased naldemedine concentrations; monitor for adverse reactions P-gp inhibitors (e.g., cyclosporine): Monitor for adverse reactions