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Armodafinil and Kaletra

Determining the interaction of Armodafinil and Kaletra and the possibility of their joint administration.

Check result:

Armodafinil <> Kaletra

Relevance: 23.08.2022 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:

Using armodafinil together with lopinavir may decrease the effects of lopinavir. Contact your doctor if your condition changes. If your doctor does prescribe these medications together, you may need a dose adjustment or special test 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 modafinil (the racemate) or armodafinil (the R-enantiomer) may decrease the plasma concentrations of protease inhibitors (PIs). The mechanism involves induction of intestinal CYP450 3A4-mediated first-pass metabolism by modafinil and armodafinil, with possible secondary induction of hepatic 3A4 metabolism. Significant intestinal metabolism appears to occur with indinavir and saquinavir but has not been studied with other PIs. Conversely, PIs may increase the plasma concentrations of modafinil via inhibition of hepatic CYP450 3A4 metabolism. The clinical significance is unknown. However, the possibility of prolonged and/or increased pharmacologic effects of modafinil should be considered.

MANAGEMENT: Given the risk of reduced viral susceptibility and resistance development associated with decreased or subtherapeutic antiretroviral drug levels, caution is advised if modafinil or armodafinil must be used in patients treated with PIs, particularly if they are using only one PI in their antiretroviral regimen. Clinical monitoring for altered effects of both modafinil and the PI may be appropriate following addition or withdrawal of one or the other drug.

References

Doherty MM, Charman WN "The mucosa of the small intestine: how clinically relevant as an organ of drug metabolism?" Clin Pharmacokinet 41 (2002): 235-53
Sommadossi JP "HIV protease inhibitors: pharmacologic and metabolic distinctions." AIDS 13 (1999): s29-40
"Product Information. Nuvigil (armodafinil)." Cephalon Inc, West Chester, PA.
Durant J, Clevenbergh P, Garraffo R, Halfon P, Icard S, DelGiudice P, Montagne N, Schapiro JM, Dellamonica P "Importance of protease inhibitor plasma levels in HIV-infected patients treated with genotypic-guided therapy: pharmacological data from the Viradapt Study." Aids 14 (2000): 1333-9
Barry M, Gibbons S, Back D, Mulcahy F "Protease inhibitors in patients with HIV disease. Clinically important pharmacokinetic considerations." Clin Pharmacokinet 32 (1997): 194-209
Robertson P, Decory HH, Madan A, Parkinson A "In vitro inhibition and induction of human hepatic cytochrome P450 enzymes by modafinil." Drug Metab Dispos 28 (2000): 664-71
"Product Information. Provigil (modafinil)." Cephalon, Inc, West Chester, PA.

Armodafinil

Generic Name: armodafinil

Brand name: Nuvigil

Synonyms: n.a.

What is Armodafinil?

Kaletra

Generic Name: lopinavir / ritonavir

Brand name: Kaletra

Synonyms: n.a.

What is Kaletra?

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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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