Phenytoin Sodium, Prompt injection and Sublocade

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.

Due to their effects on the central nervous system, using buprenorphine together with phenytoin may occasionally lead to serious side effects such as respiratory distress, coma, or even death. In addition, phenytoin may reduce the blood levels of buprenorphine, which may make the medication less effective. If you have been receiving treatment with buprenorphine, adding phenytoin may also cause you to experience unpleasant withdrawal symptoms such as watery eyes, runny nose, sneezing, yawning, excessive sweating, goose bumps, fever, chills, flushing, restlessness, irritability, anxiety, depression, pupil dilation, tremor, rapid heart beat, body aches, involuntary twitching and kicking, abdominal cramping, loss of appetite, nausea, vomiting, diarrhea, and weight loss. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Make sure you take these medications exactly as prescribed to you, and avoid drinking alcohol during treatment. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. 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.

MONITOR CLOSELY: Concomitant use of buprenorphine with other central nervous system (CNS) depressants has been associated with increased risk of buprenorphine overdose, severe respiratory depression, coma, and death. Reported cases have primarily occurred in the setting of buprenorphine maintenance treatment for opiate addiction, and many involved abuse or misuse of buprenorphine including intravenous self-injection with concomitant use of benzodiazepines or alcohol. The exact mechanism of interaction is unknown, but preclinical studies suggest that benzodiazepines can alter the usual ceiling effect on buprenorphine-induced respiratory depression and render the respiratory effects of buprenorphine appear similar to those of full opioid agonists.

MANAGEMENT: Extreme caution is advised when prescribing buprenorphine in conjunction with other CNS depressants, or when prescribing buprenorphine to patients who are addicted to opioids and also abusing benzodiazepines or alcohol. Due to potential risk of overdose and death, dependence on sedative-hypnotics such as benzodiazepines or alcohol is considered a relative contraindication for office-based buprenorphine treatment of opioid addiction. Dosage reduction of CNS depressants, buprenorphine, or both should be considered if concomitant use is necessary.

MONITOR CLOSELY: Coadministration with potent inducers of CYP450 3A4, including certain anticonvulsants such as carbamazepine, phenobarbital, phenytoin and primidone, may decrease the plasma concentrations of buprenorphine, which is primarily metabolized by the isoenzyme. Reduced efficacy or withdrawal symptoms may occur in patients maintained on buprenorphine.

MANAGEMENT: Pharmacologic response to buprenorphine should be monitored more closely whenever a CYP450 3A4 inducer is added to or withdrawn from therapy, and the buprenorphine dosage adjusted as necessary.

Phenytoin Sodium, Prompt injection

Generic Name: phenytoin

Brand name: Dilantin, Phenytoin Sodium, Prompt, Phenytek, Dilantin Infatabs

Synonyms: Phenytoin Sodium, Prompt (injection)

What is Phenytoin Sodium, Prompt injection?

Sublocade

Generic Name: buprenorphine

Brand name: Sublocade, Belbuca, Buprenex, Probuphine, Butrans, Subutex

Synonyms: Sublocade Injection

What is Sublocade?