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Enablex and Kaletra

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

Check result:
Enablex <> Kaletra
Relevance: 13.05.2022 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:

Ritonavir may significantly increase the blood levels of darifenacin. This can increase side effects such as nausea, dry mouth, abdominal pain, constipation, and heartburn. Talk to you doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or 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:

ADJUST DOSE: Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of darifenacin, which is partially metabolized by the isoenzyme. Darifenacin is also metabolized by CYP450 2D6, but 3A4 is the major pathway of metabolism in so-called poor metabolizers of 2D6 (approximately 7% of Caucasians and 2% of Asians and those of African descent). In a drug interaction study involving 10 extensive metabolizers and 1 poor metabolizer of 2D6, coadministration with the potent 3A4 inhibitor ketoconazole (400 mg) increased the mean steady-state peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of darifenacin (extended-release 7.5 mg once a day) approximately 5-fold each compared to values previously reported for extensive metabolizers of 2D6. In the poor metabolizer, Cmax and AUC of darifenacin increased approximately 13-fold each compared to values previously reported for poor metabolizers. When a 15 mg daily dose of extended-release darifenacin was given with ketoconazole, mean darifenacin Cmax and AUC in 3 extensive metabolizers increased approximately 12-fold compared to historical values, while Cmax and AUC increased approximately 6-fold in the poor metabolizer compared to historical values.

MANAGEMENT: The dosage of darifenacin should not exceed 7.5 mg/day when used with potent CYP450 3A4 inhibitors.

References
  • "Product Information. Enablex (darifenacin)." Novartis Pharmaceuticals, East Hanover, NJ.
  • Niwa T, Shiraga T, Takagi A "Effect of antifungal drugs on cytochrome P450 (CYP) 2C9, CYP2C19, CYP3A4 activities in human liver microsomes." Biol Pharm Bull 28 (2005): 1805-8
Enablex

Generic Name: darifenacin

Brand name: Enablex

Synonyms: n.a.

Kaletra

Generic Name: lopinavir / ritonavir

Brand name: Kaletra

Synonyms: n.a.

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.

Interaction with food and lifestyle
Disease interaction