Istradefylline interactions
Full monograph for IstradefyllineCheck it against another medicine
Medicines
115 documented
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Apalutamide | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of istradefylline, which is primarily metabolized by… | 3 sources — open the full entry |
| Carbamazepine | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of istradefylline, which is primarily metabolized by… | 3 sources — open the full entry |
| Ceritinib | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations and risk of adverse effects of istradefylline, which… | 4 sources — open the full entry |
| Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations and risk of adverse effects of istradefylline, which… | 4 sources — open the full entry |
| Colchicine | Major | Excretion | Coadministration with inhibitors of P-glycoprotein (P-gp) may significantly increase the serum concentrations of colchicine. The mechanism involves enhanced… | 78 sources — open the full entry |
| Enzalutamide | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of istradefylline, which is primarily metabolized by… | 3 sources — open the full entry |
| Esomeprazole + Amoxicillin + Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations and risk of adverse effects of istradefylline, which… | 4 sources — open the full entry |
| Fosphenytoin Sodium | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of istradefylline, which is primarily metabolized by… | 3 sources — open the full entry |
| Itraconazole | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations and risk of adverse effects of istradefylline, which… | 4 sources — open the full entry |
| Ketoconazole | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations and risk of adverse effects of istradefylline, which… | 4 sources — open the full entry |
| Ketoconazole + Zinc Pyrithione + Aleovera | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations and risk of adverse effects of istradefylline, which… | 4 sources — open the full entry |
| Lansoprazole + Amoxicillin + Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations and risk of adverse effects of istradefylline, which… | 4 sources — open the full entry |
| Lopinavir + Ritonavir | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations and risk of adverse effects of istradefylline, which… | 4 sources — open the full entry |
| Nelfinavir | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations and risk of adverse effects of istradefylline, which… | 4 sources — open the full entry |
| Nirmatrelvir + Ritonavir | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations and risk of adverse effects of istradefylline, which… | 4 sources — open the full entry |
| Phenobarbital | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of istradefylline, which is primarily metabolized by… | 3 sources — open the full entry |
| Phenytoin Sodium | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of istradefylline, which is primarily metabolized by… | 3 sources — open the full entry |
| Posaconazole | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations and risk of adverse effects of istradefylline, which… | 4 sources — open the full entry |
| Primidone | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of istradefylline, which is primarily metabolized by… | 3 sources — open the full entry |
| Rabeprazole + Amoxicillin + Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations and risk of adverse effects of istradefylline, which… | 4 sources — open the full entry |
| Rifampicin | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of istradefylline, which is primarily metabolized by… | 3 sources — open the full entry |
| Rifampicin + Isoniazid | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of istradefylline, which is primarily metabolized by… | 3 sources — open the full entry |
| Rifampicin + Isoniazid + Pyrazinamide + Ethambutol | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of istradefylline, which is primarily metabolized by… | 3 sources — open the full entry |
| Tucatinib | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations and risk of adverse effects of istradefylline, which… | 4 sources — open the full entry |
| Venetoclax | Major | Absorption | Coadministration with P-glycoprotein (P-gp) inhibitors may increase the plasma concentrations of venetoclax, which is a substrate of this efflux transporter. | 5 sources — open the full entry |
| Vonoprazan + Amoxicillin + Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations and risk of adverse effects of istradefylline, which… | 4 sources — open the full entry |
| Voriconazole | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations and risk of adverse effects of istradefylline, which… | 4 sources — open the full entry |
| Abametapir | Moderate | Metabolism | Based on in vitro inhibition data, a single topical application of abametapir lotion may increase plasma concentrations of drugs that are substrates of CYP450… | 1 sources — open the full entry |
| Abiraterone Acetate | Moderate | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may increase the plasma concentrations of istradefylline, which is primarily metabolized by CYP450 3A4… | 34 sources — open the full entry |
| Afatinib Dimaleate | Moderate | Others | Coadministration with inhibitors of P-glycoprotein (P-gp) may increase the plasma concentrations of afatinib, which is a substrate of the efflux transporter. | 4 sources — open the full entry |
| Ambrisentan | Moderate | Others | Coadministration with istradefylline may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) transporter. The proposed… | 2 sources — open the full entry |
| Apixaban | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 and/or P-glycoprotein (P-gp) may increase the plasma concentrations of apixaban, which is a substrate of both… | 2 sources — open the full entry |
| Aprepitant | Moderate | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may increase the plasma concentrations of istradefylline, which is primarily metabolized by CYP450 3A4… | 34 sources — open the full entry |
| Artesunate | Moderate | Others | Coadministration with istradefylline may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) transporter. The proposed… | 2 sources — open the full entry |
| Asciminib | Moderate | Metabolism | Coadministration with asciminib may increase the plasma concentrations of drugs that are primarily metabolized by the CYP450 3A4 isoenzyme. The mechanism is… | 1 sources — open the full entry |
| Beclomethasone Dipropionate + Chloramphenicol + Clotrimazole + Lidocaine | Moderate | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may increase the plasma concentrations of istradefylline, which is primarily metabolized by CYP450 3A4… | 34 sources — open the full entry |
| Betrixaban | Moderate | Absorption | Coadministration with inhibitors of P-glycoprotein (P-gp) may increase the plasma concentrations of betrixaban, which is a substrate of the efflux transporter. | 4 sources — open the full entry |
| Bosentan Monohydrate | Moderate | Metabolism | Coadministration with moderate inducers of CYP450 3A4 may decrease the plasma concentrations of istradefylline, which is primarily metabolized by CYP450 3A4… | 3 sources — open the full entry |
| Calcium Dobesilate + Lidocaine + Dexamethasone | Moderate | Metabolism | Coadministration with moderate inducers of CYP450 3A4 may decrease the plasma concentrations of istradefylline, which is primarily metabolized by CYP450 3A4… | 3 sources — open the full entry |
| Cenobamate | Moderate | Metabolism | Coadministration with moderate inducers of CYP450 3A4 may decrease the plasma concentrations of istradefylline, which is primarily metabolized by CYP450 3A4… | 3 sources — open the full entry |
| Chloramphenicol (Oral) | Moderate | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may increase the plasma concentrations of istradefylline, which is primarily metabolized by CYP450 3A4… | 34 sources — open the full entry |
| Chloramphenicol + Lidocaine Hydrochloride | Moderate | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may increase the plasma concentrations of istradefylline, which is primarily metabolized by CYP450 3A4… | 34 sources — open the full entry |
| CiprofloxacinbaseOphthalmic | Moderate | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may increase the plasma concentrations of istradefylline, which is primarily metabolized by CYP450 3A4… | 34 sources — open the full entry |
| Ciprofloxacin + Dexamethasone | Moderate | Metabolism | Coadministration with moderate inducers of CYP450 3A4 may decrease the plasma concentrations of istradefylline, which is primarily metabolized by CYP450 3A4…2 documented mechanisms | 37 sources — open the full entry |
| Ciprofloxacin + Hydrocortisone Acetate | Moderate | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may increase the plasma concentrations of istradefylline, which is primarily metabolized by CYP450 3A4… | 34 sources — open the full entry |
| Crizotinib | Moderate | Metabolism | Coadministration with crizotinib may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. The mechanism is decreased… | 2 sources — open the full entry |
| Cyclosporine (Oral) | Moderate | Others | Coadministration with istradefylline may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) transporter. The proposed… | 2 sources — open the full entry |
| Dabigatran Etexilate Mesylate | Moderate | Metabolism | Coadministration with istradefylline may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) transporter. The proposed… | 1 sources — open the full entry |
| Daunorubicin | Moderate | Absorption | Coadministration with inhibitors of P-glycoprotein (P-gp) may increase the plasma concentrations of daunorubicin and idarubicin, both of which are substrates… | 5 sources — open the full entry |
| Dexamethasone | Moderate | Metabolism | Coadministration with moderate inducers of CYP450 3A4 may decrease the plasma concentrations of istradefylline, which is primarily metabolized by CYP450 3A4… | 3 sources — open the full entry |
Food & lifestyle
cigarette
ModerateOthers
Smoking tobacco may decrease the steady-state systemic exposure of istradefylline by 38% to 54%.
What to do: The possibility of reduced therapeutic effects of istradefylline should be considered in smokers. The manufacturer recommends an istradefylline dosage of 40 mg once daily in patients who smoke 20 or more cigarettes (or the equivalent amount of another tobacco product) per day.
1 source
- "Product Information. Nourianz (istradefylline)." Kyowa Kirin, Inc (2019):
Conditions
Conditions in which Istradefylline needs care, as documented in this source.
Liver Failure
MajorIstradefylline has not been studied in patients with severe hepatic impairment (Child-Pugh Class C), and its use should be avoided in these patients. In patients with moderate hepatic impairment (Child-Pugh B), the steady-state exposures were predicted to be 3.3-fold higher. Therefore, the maximum recommended dosage of istradefylline in patients with moderate hepatic impairment (Child-Pugh B) is 20 mg once daily. Patients should be closely monitored for adverse events when receiving treatment. No dose adjustment is needed in patients with mild hepatic impairment.
1 source
- "Product Information. Nourianz (istradefylline)." Kyowa Kirin, Inc (2019):
Kidney Failure, Chronic
ModerateIstradefylline has not been evaluated in patients with end-stage renal disease (ESRD) (CrCl <15 mL/min) or ESRD requiring hemodialysis. Caution is advised if prescribed in these patients. No dosage adjustment is needed in patients with mild, moderate or severe renal impairment.
1 source
- "Product Information. Nourianz (istradefylline)." Kyowa Kirin, Inc (2019):
Psychotic Disorders
ModerateBecause of the potential risk of exacerbating psychosis, patients with a major psychotic disorder should not be treated with istradefylline. Consider dosage reduction or discontinuation if a patient develops hallucinations or psychotic behaviors while taking this drug.
1 source
- "Product Information. Nourianz (istradefylline)." Kyowa Kirin, Inc (2019):