Zolpidem with Fosnetupitant Interaction Details
Brand Names Associated with Zolpidem
- Ambien®
- Ambien® CR
- Edluar®
- Intermezzo®
- Zolpidem
- Zolpimist®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 12, 2023
Interaction Effect
Increased exposure of CYP3A4 substrate
Interaction Summary
Coadministration of netupitant, a moderate inhibitor of CYP3A4, with a CYP3A4 substrate may increase the plasma concentration of the CYP3A4 substrate. The mean AUC and Cmax of the CYP3A4 substrate erythromycin was increased following the coadministration of netupitant in a pharmacokinetic study. Increases in the AUC of dexamethasone, a CYP3A4 probe substrate, remained for up to 8 days following a single dose of netupitant. The concomitant use of CYP3A4 substrates with netupitant should be avoided for 1 week. If a CYP3A4 substrate must be administered within 1 week of netupitant, consider reducing the dose of the CYP3A4 substrate.
Severity
Major
Onset
Rapid
Evidence
Theoretical
How To Manage Interaction
Avoid concomitant use of CYP3A4 substrates with netupitant (a moderate inhibitor of CYP3A4) for 1 week. If a CYP3A4 substrate must be administered within 1 week of netupitant, consider reducing the dose of the CYP3A4 substrate.
Mechanism Of Interaction
Inhibition of CYP3A4-mediated metabolism by netupitant
Literature Reports
A) In one study where the duration of CYP3A4 inhibition was assessed using dexamethasone as a CYP3A4 probe substrate, the mean AUC of dexamethasone increased by 1.6-fold on day 1, 2.4-fold on day 4, 1.5-fold on day 6, and 1.2-fold on day 8 after a single dose of the combination netupitant 300 mg/palonosetron 0.5 mg was coadministered to participants on day 1. The participants had been treated with a dexamethasone regimen of 12 mg on day 1 followed by 8 mg on days 2, 3, 4, 6, 8, and 10 .
B) A pharmacokinetic study demonstrated that when erythromycin 500 mg was coadministered with netupitant 300 mg, the mean AUC of erythromycin increased by 56% and the Cmax increased by 92% .
Zolpidem Overview
-
Zolpidem is used to treat insomnia (difficulty falling asleep or staying asleep). Zolpidem belongs to a class of medications called sedative-hypnotics. It works by slowing activity in the brain to allow sleep.
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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.