Interactions : אינטראקציות

7. DRUG INTERACTIONS
7.1 Strong CYP2D6 Inhibitors
A reduction in AUSTEDO dose may be necessary when adding a strong CYP2D6 inhibitor in patients maintained on a stable dose of AUSTEDO. Concomitant use of strong CYP2D6 inhibitors (e.g., paroxetine, fluoxetine, quinidine, bupropion) has been shown to increase the systemic exposure to the active dihydro-metabolites of deutetrabenazine by approximately 3-fold. The daily dose of AUSTEDO should not exceed 36 mg per day, and the maximum single dose of AUSTEDO should not exceed 18 mg in patients taking strong CYP2D6 inhibitors [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3)].


7.2 Reserpine
Reserpine binds irreversibly to VMAT2 and the duration of its effect is several days. Prescribers should wait for chorea or dyskinesia to reemerge before administering AUSTEDO to help reduce the risk of overdosage and major depletion of serotonin and norepinephrine in the central nervous system. At least 20 days should elapse after stopping reserpine before starting AUSTEDO.
AUSTEDO and reserpine should not be used concomitantly [see Contraindications (4)].

7.3 Monoamine Oxidase Inhibitors (MAOIs)
AUSTEDO is contraindicated in patients taking MAOIs. AUSTEDO should not be used in combination with an MAOI, or within 14 days of discontinuing therapy with an MAOI [see Contraindications (4)].

7.4 Neuroleptic Drugs
The risk of parkinsonism, NMS, and akathisia may be increased by concomitant use of AUSTEDO and dopamine antagonists or antipsychotics.

7.5 Alcohol or Other Sedating Drugs
Concomitant use of alcohol or other sedating drugs may have additive effects and worsen sedation and somnolence [see Warnings and Precautions (5.7)].

7.6 Concomitant Tetrabenazine or Valbenazine
AUSTEDO is contraindicated in patients currently taking tetrabenazine or valbenazine.
AUSTEDO may be initiated the day following discontinuation of tetrabenazine [see Dosage and Administration (2.2)].