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Lorlatinib and Zolpidem Oral, Oromucosal

Determining the interaction of Lorlatinib and Zolpidem Oral, Oromucosal and the possibility of their joint administration.

Check result:
Lorlatinib <> Zolpidem Oral, Oromucosal
Relevance: 11.09.2023 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:

Lorlatinib may reduce the blood levels of zolpidem, which may make the medication less effective in treating your insomnia. Talk to your 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 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 CYP450 inducers may decrease the plasma concentrations of zolpidem, which is primarily metabolized by CYP450 3A4 and, to a lesser extent, by CYP450 1A2. In eight healthy female volunteers, administration of a single 20 mg dose of zolpidem following pretreatment with the potent CYP450 inducer rifampin (600 mg/day for 5 days) decreased mean zolpidem peak plasma concentration (Cmax) and systemic exposure (AUC) by 58% and 73%, respectively, compared to administration following placebo. These changes were associated with significant reductions in the pharmacodynamic effects of zolpidem. In another study with 18 healthy volunteers, administration of a single 5 mg dose of zolpidem following daily dosing of carbamazepine 400 mg for 15 days resulted in a 41% decrease in mean Cmax and 57% decrease in mean AUC of zolpidem compared to administration of zolpidem alone.

MANAGEMENT: The potential for diminished pharmacologic effects of zolpidem should be considered during coadministration with CYP450 inducers, particularly potent ones like carbamazepine, enzalutamide, lumacaftor, mitotane, phenobarbital, phenytoin, rifamycins, and St. John's wort. Alternative treatments or a dosage adjustment for zolpidem may be required if an interaction is suspected.

References
  • Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  • Villikka K, Kivisto KT, Luurila H, Neuvonen PJ "Rifampin reduces plasma concentrations and effects of zolpidem." Clin Pharmacol Ther 62 (1997): 629-34
  • Vlase L, Popa A, Neag M, Muntean D, Baldea I, Leucuta SE "Pharmacokinetic Interaction Between Zolpidem and Carbamazepine in Healthy Volunteers." J Clin Pharmacol (2010):
  • "Product Information. Ambien (zolpidem)." sanofi-aventis, Bridgewater, NJ.
Lorlatinib

Generic Name: lorlatinib

Brand name: Lorbrena

Synonyms: n.a.

Zolpidem Oral, Oromucosal

Generic Name: zolpidem

Brand name: Ambien, Ambien CR, Edluar, Intermezzo, ZolpiMist

Synonyms: Zolpidem

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