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Abilify MyCite and Wakix

Determining the interaction of Abilify MyCite and Wakix and the possibility of their joint administration.

Check result:
Abilify MyCite <> Wakix
Relevance: 22.09.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Consumer information for this interaction is not currently available.GENERALLY AVOID: Limited data suggest that pitolisant may produce mild to moderate QT interval prolongation (10 to 13 milliseconds) at doses 3 to 6 times the standard therapeutic dose. Theoretically, concurrent use of two or more drugs that can cause QT interval prolongation may result in additive effects and increased risk of ventricular arrhythmias including torsade de pointes and sudden death. In general, the risk of an individual agent or a combination of these agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). In addition, the extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drugs. MONITOR: Coadministration with pitolisant may decrease the plasma concentrations and therapeutic effects of drugs that are primarily metabolized by CYP450 3A4. Pitolisant is a borderline/weak inducer of CYP450 3A4. When studied with midazolam, a probe substrate for CYP450 3A4, pitolisant was found to reduce midazolam peak plasma concentration (Cmax) and systemic exposure (AUC) by less than 25%. MANAGEMENT: Concomitant use of pitolisant with other agents associated with QT interval prolongation should generally be avoided. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope. In addition, it may be advisable to avoid concomitant use of pitolisant with sensitive CYP450 3A4 substrates or those that demonstrate a narrow therapeutic index, if possible (e.g., ergot alkaloids, alfentanil, cisapride, colchicine, cyclosporine, fentanyl, ivacaftor, macrolide immunosuppressants, oral midazolam, pimozide, quinidine, sufentanil, triazolam, vinca alkaloids). Caution is advised if pitolisant is used in combination with these drugs. Clinical and laboratory monitoring may be appropriate whenever pitolisant is added to or withdrawn from therapy, and dosage adjustments made if necessary. References Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0 "Product Information. Wakix (pitolisant)." Harmony Biosciences, LLC, Plymouth Meeting, PA.

Professional:

GENERALLY AVOID: Limited data suggest that pitolisant may produce mild to moderate QT interval prolongation (10 to 13 milliseconds) at doses 3 to 6 times the standard therapeutic dose. Theoretically, concurrent use of two or more drugs that can cause QT interval prolongation may result in additive effects and increased risk of ventricular arrhythmias including torsade de pointes and sudden death. In general, the risk of an individual agent or a combination of these agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). In addition, the extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drugs.

MONITOR: Coadministration with pitolisant may decrease the plasma concentrations and therapeutic effects of drugs that are primarily metabolized by CYP450 3A4. Pitolisant is a borderline/weak inducer of CYP450 3A4. When studied with midazolam, a probe substrate for CYP450 3A4, pitolisant was found to reduce midazolam peak plasma concentration (Cmax) and systemic exposure (AUC) by less than 25%.

MANAGEMENT: Concomitant use of pitolisant with other agents associated with QT interval prolongation should generally be avoided. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope. In addition, it may be advisable to avoid concomitant use of pitolisant with sensitive CYP450 3A4 substrates or those that demonstrate a narrow therapeutic index, if possible (e.g., ergot alkaloids, alfentanil, cisapride, colchicine, cyclosporine, fentanyl, ivacaftor, macrolide immunosuppressants, oral midazolam, pimozide, quinidine, sufentanil, triazolam, vinca alkaloids). Caution is advised if pitolisant is used in combination with these drugs. Clinical and laboratory monitoring may be appropriate whenever pitolisant is added to or withdrawn from therapy, and dosage adjustments made if necessary.

References
  • Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  • "Product Information. Wakix (pitolisant)." Harmony Biosciences, LLC, Plymouth Meeting, PA.
Abilify MyCite

Generic Name: aripiprazole

Brand name: Abilify MyCite, Abilify, Abilify Discmelt, Abilify Maintena, Aristada, Aristada Initio

Synonyms: Abilify Mycite

Wakix

Generic Name: pitolisant

Brand name: Wakix

Synonyms: Wakix Tablets

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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