Daridorexant with Cyclosporine Interaction Details
Brand Names Associated with Daridorexant
- Daridorexant
- QUVIVIQ®
Brand Names Associated with Cyclosporine
- Cyclosporine
- Gengraf®
- Neoral®
- Sandimmune® Capsules
- Sandimmune® Oral Solution
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Mar 07, 2024
Interaction Effect
Increased daridorexant and cycloSPORINE exposure
Interaction Summary
Concomitant use of daridorexant (CYP3A4 substrate) with cycloSPORINE (a moderate CYP3A4 inhibitor and a P-gp substrate with NTI) increases exposure to daridorexant and cycloSPORINE, which may increase the risk of adverse reactions. If used concomitantly, use caution and do not exceed daridorexant dose of 25 mg once per night[1].
Severity
Major
Onset
Unspecified
Evidence
Probable
How To Manage Interaction
Concomitant use of daridorexant (CYP3A4 substrate) with cycloSPORINE (a moderate CYP3A4 inhibitor and a P-gp substrate with NTI) increases exposure to daridorexant and cycloSPORINE, which may increase the risk of adverse reactions. If used concomitantly, use caution and do not exceed daridorexant dose of 25 mg once per night[1].
Mechanism Of Interaction
Inhibition of CYP3A4-mediated metabolism of daridorexant; inhibition of P-gp-mediated efflux transport of daridorexant
Literature Reports
A) Concomitant use of daridorexant 25 mg and dilTIAZem (moderate CYP3A4 inhibitor) 240 mg increased daridorexant AUC by a geometric mean ratio (GMR) of 2.4 (90% CI, 2 to 2.8) and Cmax by a GMR of 1.4 (90% CI, 1.2 to 1.6) [1].
B) Concomitant use of steady state daridorexant 50 mg and dabigatran etexilate (P-gp substrate) 75 mg increased daridorexant AUC by a geometric mean ratio (GMR) of 1.4 (90% CI, 1.1 to 1.9) and Cmax by a GMR of 1.3 (90% CI, 1 to 1.7) [1].
References
1 ) Product Information: QUVIVIQ(R) oral tablets, daridorexant oral tablets. Idorsia Pharmaceuticals US Inc (per FDA), Radnor, PA, 2023.
Daridorexant Overview
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Daridorexant is used to treat insomnia (difficulty falling asleep or staying asleep). Daridorexant is in a class of medications called orexin receptor antagonists. It works by blocking the action of a certain natural substance in the brain that causes wakefulness.
Cyclosporine Overview
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Cyclosporine and cyclosporine (modified) are used with other medications to prevent transplant rejection (attack of the transplanted organ by the immune system of the person who received the organ) in people who have received kidney, liver, and heart transplants. Cyclosporine (modified) is also used alone or with methotrexate (Rheumatrex) to treat the symptoms of rheumatoid arthritis (arthritis caused by swelling of the lining of the joints) in patients whose symptoms were not relieved by methotrexate alone. Cyclosporine (modified) is also used to treat psoriasis (a skin disease in which red, scaly patches form on some areas of the body) in certain patients who have not been helped by other treatments. Cyclosporine and cyclosporine (modified) are in a class of medications called immunosuppressants. They work by decreasing the activity of the immune system.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.