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Actoplus Met and Phenobarbital

Determining the interaction of Actoplus Met and Phenobarbital and the possibility of their joint administration.

Check result:

Actoplus Met <> Phenobarbital

Relevance: 04.08.2023 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:

PHENobarbital may reduce the blood levels and effects of pioglitazone. Contact your doctor if your symptoms worsen or your condition changes during treatment with these medications. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring of your blood sugar to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Coadministration with inducers of CYP450 2C8 may decrease the plasma concentrations of pioglitazone, which is primarily metabolized by the isoenzyme. In 10 healthy volunteers given the potent enzyme inducer rifampin (600 mg once daily) for five days prior to coadministration with a single 30 mg dose of pioglitazone on day 6, mean pioglitazone systemic exposure (AUC) decreased by 54% and elimination half-life from 4.9 to 2.3 hours. No significant effect on peak plasma concentration or time to peak was observed.

MANAGEMENT: Because the antidiabetic effect of pioglitazone is dose- and concentration-dependent, patients treated concomitantly with a CYP450 2C8 inducer may require a higher dosage of pioglitazone. Close clinical monitoring of glycemic control is recommended following initiation or discontinuation of the CYP450 2C8 inducer, and the pioglitazone dosage adjusted as necessary.

References

Totah RA, Rettie AE "Cytochrome P450 2C8: substrates, inhibitors, pharmacogenetics, and clinical relevance." Clin Pharmacol Ther 77 (2005): 341-52
Jaakkola T, Backman JT, Neuvonen M, Laitila J, Neuvonen PJ "Effect of rifampicin on the pharmacokinetics of pioglitazone." Br J Clin Pharmacol 61 (2006): 70-8
Scheen AJ "Pharmacokinetic interactions with thiazolidinediones." Clin Pharmacokinet 46 (2007): 1-12
"Product Information. Actos (pioglitazone)" Takeda Pharmaceuticals America, Lincolnshire, IL.
Jaakkola T, Laitila J, Neuvonen PJ, Backman JT "Pioglitazone is metabolised by CYP2C8 and CYP3A4 in vitro: potential for interactions with CYP2C8 inhibitors." Basic Clin Pharmacol Toxicol 99 (2006): 44-51

Actoplus Met

Generic Name: metformin / pioglitazone

Brand name: Actoplus Met, Actoplus Met XR

Synonyms: n.a.

What is Actoplus Met?

Phenobarbital

Generic Name: phenobarbital

Brand name: Solfoton, Luminal

Synonyms: PHENobarbital

What is Phenobarbital?

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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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