Methylprednisolone with Nefazodone Interaction Details
Brand Names Associated with Methylprednisolone
- Medrol®
- Methylprednisolone
Brand Names Associated with Nefazodone
- Nefazodone
- Serzone®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 03, 2023
Interaction Effect
Increased methylPREDNISolone exposure, prolonged cortisol suppression
Interaction Summary
Nefazodone is a potent and selective inhibitor of cytochrome P450 3A4 and inhibits the metabolism of methylPREDNISolone. Exposure to methylPREDNISolone was significantly increased during coadministration of methylPREDNISolone and nefazodone. Cortisol suppression was also significantly longer with the combination.
Severity
Moderate
Onset
Rapid
Evidence
Probable
How To Manage Interaction
Patients receiving methylPREDNISolone may require a dosage change when nefazodone is added or deleted from their drug regimens. Monitor for adverse effects of methylPREDNISolone (neuropsychiatric reactions, fluid and electrolyte disturbances, hypertension, hyperglycemia).
Mechanism Of Interaction
Inhibition of CYP450 3A4 metabolism of methylPREDNISolone by nefazodone
Literature Reports
A) The effect of 9 days of nefazodone therapy on the pharmacokinetics of a single dose of methylPREDNISolone were analyzed in an open label, sequential, two phase, repeated measure study which included 8 patients. Patients received nefazodone 100 milligrams (mg) every 12 hours for three doses, then 150 mg every 12 hours for four doses, followed by 200 mg every 12 hours until discharge from the clinical research center. The methylPREDNISolone 0.6 mg/kg intravenous bolus was administered as a single injection. All methylPREDNISolone pharmacokinetics analyzed were found to be significantly different between the two study phases. Following nefazodone administration, there was a significant increase of the mean methylPREDNISolone area under the concentration time curve (AUC) (1393 mcg-h/L versus 2966 mcg-h/L, p < 0.005) and half-life (2.28 hours versus 3.32 hours, p < 0.02). There was a significant decrease of methylPREDNISolone mean clearance (28.7 L/h versus 14.6 L/h, p < 0.02) and volume of distribution (91.4 L versus 64.1 L, p < 0.002). Cortisol suppression was significantly longer in patients receiving nefazodone (32 hours versus 23.3 hours). No clinically significant adverse effects were reported .
Methylprednisolone Overview
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Methylprednisolone, a corticosteroid, is similar to a natural hormone produced by your adrenal glands. It is often used to replace this chemical when your body does not make enough of it. It relieves inflammation (swelling, heat, redness, and pain) and is used to treat certain forms of arthritis; skin, blood, kidney, eye, thyroid, and intestinal disorders (e.g., colitis); severe allergies; and asthma. Methylprednisolone is also used to treat certain types of cancer.
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This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Nefazodone Overview
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Nefazodone is used to treat depression. Nefazodone is in a class of medications called serotonin modulators. It works by increasing the amounts of certain natural substances in the brain that are needed to maintain mental balance.
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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.