Posted by Sobriquet Style on June 3, 2006, at 8:44:55
"clonazepam and modafinil (minor Drug-Drug)
Description:
Coadministration with modafinil may decrease the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. Modafinil is a modest inducer of CYP450 3A4 in vitro, and pharmacokinetic studies suggest that its effects may be primarily intestinal rather than hepatic. Thus, clinically significant interactions would most likely be expected with drugs that have low oral bioavailability due to significant intestinal CYP450 3A4-mediated first-pass metabolism (e.g., buspirone, cyclosporine, felodipine, lovastatin, midazolam, nifedipine, nisoldipine, saquinavir, simvastatin, sirolimus, tacrolimus, triazolam, verapamil). However, the potential for interaction should be considered with any drug metabolized by CYP450 3A4, especially given the high degree of interpatient variability with respect to CYP450-mediated metabolism. Pharmacologic response to these drugs may be altered and should be monitored more closely whenever modafinil is added to or withdrawn from therapy. Dosage adjustments may be required if an interaction is suspected."-
Vs.
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"diazepam and modafinil (moderate Drug-Drug)
Description:MONITOR:
Based on in vitro inhibition data, coadministration with modafinil may increase the plasma concentrations of drugs that are substrates of the CYP450 2C9 and/or 2C19 isoenzymes. The mechanism is decreased clearance due to inhibition of CYP450 2C9/2C19 activities by modafinil. Pharmacologic response to these drugs may be altered, particularly if they have a narrow therapeutic range. For example, modafinil was implicated in a case of clozapine toxicity, characterized by dizziness, ataxia, and tachycardia. Clozapine serum levels increased from 761 ng/mL to 1400 ng/mL several weeks after concurrent modafinil therapy was initiated."Can you describe what they are saying *basically* :-)
(source is from http://www.drugs.com/drug_interactions.html and is about interaction with either diazepam (valium) and clonazepam (klonopin) - interacting with Provigil.)
Thanks!
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poster:Sobriquet Style
thread:652288
URL: http://www.dr-bob.org/babble/20060530/msgs/652288.html