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Darunavir Tablets and Quetiapine Fumarate Tablets

Determining the interaction of Darunavir Tablets and Quetiapine Fumarate Tablets and the possibility of their joint administration.

Check result:
Darunavir Tablets <> Quetiapine Fumarate Tablets
Relevance: 17.05.2023 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:

Darunavir may increase the blood levels of QUEtiapine. You may be more likely to experience side effects such as dizziness; drowsiness; dry mouth; constipation; increased appetite; weight gain; increased blood sugar and cholesterol or triglyceride levels; cognitive and motor impairment; involuntary muscle movements involving the face, tongue, or other parts of the body; difficulty swallowing; low blood pressure (especially at the start of treatment or after a dose increase); blood pressure increases (reported in children and teenagers); irregular heart rhythm; and seizures. Let your doctor know if your condition changes or you experience increased side effects. You may need a dose adjustment or more frequent monitoring by your doctor 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 inhibitors of CYP450 3A4 may increase the plasma concentrations of quetiapine, which is primarily metabolized by the isoenzyme. In 12 healthy volunteers, administration of a single 25 mg dose of quetiapine with the potent CYP450 3A4 inhibitor ketoconazole (200 mg once daily for 4 days) increased mean quetiapine peak plasma concentration (Cmax) and systemic exposure (AUC) by 3.4- and 6.2-fold, respectively, and decreased mean oral clearance by 84% compared to quetiapine administered alone. A case report describes a patient treated with quetiapine 700 mg/day who developed severely impaired consciousness and respiratory depression requiring intensive care surveillance following two 500 mg doses of clarithromycin, another potent CYP450 3A4 inhibitor. Quetiapine plasma level was found to be nearly 5 times the high end of the recommended therapeutic range. The patient recovered a week after quetiapine was withdrawn. The interaction was also suspected in a case report of two patients receiving quetiapine with ritonavir-boosted atazanavir. One patient experienced significant increases in appetite and serum glucose and a weight gain of more than 22 kg over six months. The patient's weight returned to baseline five months after stopping both treatments. The second patient had increased sedation and mental confusion, which resolved several days following self-discontinuation of quetiapine.

MANAGEMENT: Pharmacologic response to quetiapine should be monitored more closely whenever a CYP450 3A4 inhibitor is added to or withdrawn from therapy, and the quetiapine dosage adjusted as necessary. Patients should be monitored for potentially increased adverse effects such as dizziness, drowsiness, dry mouth, constipation, increased appetite, weight gain, extrapyramidal symptoms, tardive dyskinesia, hyperglycemia, dyslipidemia, hyperprolactinemia (galactorrhea, amenorrhea, gynecomastia), orthostatic hypotension, blood pressure increases (in children and adolescents), QT prolongation, cognitive and motor impairment, dysphagia, and heat-related illnesses due to disruption of body temperature regulation.

References
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  • DeVane CL, Nemeroff CB "Clinical pharmacokinetics of quetiapine - An atypical antipsychotic." Clin Pharmacokinet 40 (2001): 509-22
  • Hantson P, Di Fazio V, Wallemacq P "Toxicokinetic interaction between quetiapine and antiretroviral therapy following quetiapine overdose." Drug Metab Lett 4 (2010): 7-8
  • Grimm SW, Richtand NM, Winter HR, Stams KR, Reele SB "Effects of cytochrome P450 3A modulators ketoconazole and carbamazepine on quetiapine pharmacokinetics." Br J Clin Pharmacol 61 (2006): 58-69
  • Schulz-Du Bois C, Schulz-Du Bois AC, Bewig B, et al. "Major increase of quetiapine steady-state plasma concentration following co-administration of clarithromycin: confirmation of the pharmacokinetic interaction potential of quetiapine." Pharmacopsychiatry 41 (2008): 258-9
  • Spina E, Scordo MG, D'Arrigo C "Metabolic drug interactions with new psychotropic agents." Fundam Clin Pharmacol 17 (2003): 517-38
  • Urichuk L, Prior TI, Dursun S, Baker G "Metabolism of atypical antipsychotics: involvement of cytochrome p450 enzymes and relevance for drug-drug interactions." Curr Drug Metab 9 (2008): 410-8
  • "Product Information. Seroquel (quetiapine)." Zeneca Pharmaceuticals, Wilmington, DE.
Darunavir Tablets

Generic Name: darunavir

Brand name: Prezista

Synonyms: Darunavir

Quetiapine Fumarate Tablets

Generic Name: quetiapine

Brand name: Seroquel, Seroquel XR

Synonyms: Quetiapine, QUEtiapine

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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