Perampanel interactions
Full monograph for PerampanelCheck it against another medicine
Medicines
205 documented
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Alprazolam | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Amitriptyline Hydrochloride | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Amitriptyline Hydrochloride + Chlordiazepoxide | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…2 documented mechanisms | 44 sources — open the full entry |
| Apalutamide | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations and pharmacologic effects of perampanel, which is primarily metabolized by… | 2 sources — open the full entry |
| Aripiprazole | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Asenapine Maleate | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Baclofen | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Bosentan Monohydrate | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations and pharmacologic effects of perampanel, which is primarily metabolized by… | 6 sources — open the full entry |
| Brexpiprazole | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Brivaracetam | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Bromocriptine Mesylate | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Calcium Dobesilate + Lidocaine + Dexamethasone | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations and pharmacologic effects of perampanel, which is primarily metabolized by… | 6 sources — open the full entry |
| Carbamazepine | Moderate | Metabolism | The coadministration of perampanel with other antiepileptic medications that are inducers of CYP450 3A4 may significantly decrease the plasma concentrations… | 6 sources — open the full entry |
| Carbidopa + LevodopaExtended releaseProlonged release | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 36 sources — open the full entry |
| Cariprazine | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Carisoprodol | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Cenobamate | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Cetirizine HydrochloridebaseOphthalmic | Moderate | Synergy | Concurrent use of cetirizine or levocetirizine with alcohol or other agents that exhibit central nervous system (CNS) depressant effects may result in additive… | 2 sources — open the full entry |
| Chloral Hydrate | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Chloroquine Phosphate | Moderate | Synergy | Chloroquine or hydroxychloroquine may lower the convulsive threshold, which may antagonize the action of antiepileptic medications. Seizures have been rarely… | 10 sources — open the full entry |
| Chlorpheniramine Maleate | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Chlorpromazine Hydrochloride | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Cinnarizine + Dimenhydrinate | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Ciprofloxacin + Dexamethasone | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations and pharmacologic effects of perampanel, which is primarily metabolized by… | 6 sources — open the full entry |
| Citalopram Hydrobromide | Moderate | Antagonism | The efficacy of anticonvulsants may be diminished during coadministration with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine… | 28 sources — open the full entry |
| Clobazam | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Clomipramine Hydrochloride | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Clonazepam | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Clonidine Hydrochloride | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Clozapine | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Cyclizine Hydrochloride | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Cyclobenzaprine Hydrochloride | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Cyproterone Acetate + Ethinyl Estradiol | Moderate | Metabolism | RECOMMENDED: Coadministration with certain anticonvulsants, such as rufinamide and perampanel, may reduce the efficacy of contraceptive hormones. The… | 43 sources — open the full entry |
| Dantrolene Sodium | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Deferasirox | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations and pharmacologic effects of perampanel, which is primarily metabolized by… | 2 sources — open the full entry |
| Desogestrel | Moderate | Metabolism | RECOMMENDED: Coadministration with certain anticonvulsants, such as rufinamide and perampanel, may reduce the efficacy of contraceptive hormones. The…2 documented mechanisms | 48 sources — open the full entry |
| Desvenlafaxine Succinate | Moderate | Antagonism | The efficacy of anticonvulsants may be diminished during coadministration with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine… | 28 sources — open the full entry |
| Deutetrabenazine | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Dexamethasone | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations and pharmacologic effects of perampanel, which is primarily metabolized by… | 6 sources — open the full entry |
| Dexamethasone + Chloramphenicol | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations and pharmacologic effects of perampanel, which is primarily metabolized by… | 6 sources — open the full entry |
| Dexamethasone + Levofloxacin | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations and pharmacologic effects of perampanel, which is primarily metabolized by… | 6 sources — open the full entry |
| Dexamethasone + Neomycin + Glacial Acetic Acid | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations and pharmacologic effects of perampanel, which is primarily metabolized by… | 6 sources — open the full entry |
| Dexamethasone + Neomycin Sulphate + Polymyxin B Sulphate | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations and pharmacologic effects of perampanel, which is primarily metabolized by… | 6 sources — open the full entry |
| Dexamethasone + Tobramycin | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations and pharmacologic effects of perampanel, which is primarily metabolized by… | 6 sources — open the full entry |
| Dexmedetomidine | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Dextromethorphan + Bupropion | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Dextromethorphan + Phenylephrine + Triprolidine | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…2 documented mechanisms | 44 sources — open the full entry |
| Dextromethorphan + Pseudoephedrine + Triprolidine | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…2 documented mechanisms | 44 sources — open the full entry |
| Dextromethorphan Hydrobromide | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
| Dextromethorphan Hydrobromide + Guaifenesin | Moderate | Synergy | Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these… | 44 sources — open the full entry |
Food & lifestyle
alcohol
ModerateSynergy
Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.
What to do: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
4 sources
- Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
- Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
- "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
- "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
Conditions
Conditions in which Perampanel needs care, as documented in this source.
Kidney Diseases
MajorPerampanel should be used with caution in patients with moderate renal impairment, and slower titration may be considered. No dose adjustment is required in patients with mild renal impairment. Care should be taken when prescribing this agent in patients with renal impairment, and close monitoring of renal function is recommended. The use of perampanel in patients with severe renal impairment or patients undergoing hemodialysis is not recommended.
1 source
- "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
Depressive Disorder
ModerateAntiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.
16 sources
- "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals (2002):
- "Product Information. Klonopin (clonazepam)." Roche Laboratories (2001):
- "Product Information. Dilantin (phenytoin)." Parke-Davis (2001):
- "Product Information. Cerebyx (fosphenytoin)." Parke-Davis (2001):
- "Product Information. Mysoline (primidone)." Elan Pharmaceuticals (2001):
- "Product Information. Lyrica (pregabalin)." Pfizer U.S. Pharmaceuticals Group (2005):
- "Product Information. Sabril (vigabatrin)." Lundbeck Inc (2009):
- "Product Information. Potiga (ezogabine)." GlaxoSmithKline (2011):
Show all 16 sourcesShow fewer sources
- "Product Information. Qsymia (phentermine-topiramate)." Vivus Inc (2012):
- "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
- "Product Information. Briviact (brivaracetam)." UCB Pharma Inc (2016):
- "Product Information. Diacomit (stiripentol)." Biocodex USA (2018):
- "Product Information. Epidiolex (cannabidiol)." Greenwich Biosciences LLC (2018):
- "Product Information. Xcopri (cenobamate)." SK Life Science, Inc. (2020):
- "Product Information. Fintepla (fenfluramine)." Zogenix, Inc (2020):
- "Product Information. Ztalmy (ganaxolone)." Marinus Pharmaceuticals, Inc (2022):
Hepatic Insufficiency
ModerateThe use of perampanel in patients with severe hepatic impairment is not recommended. Dosage adjustments are recommended in patients with mild or moderate hepatic impairment as the half-life of perampanel may increase in these patients. Care should be exercised when prescribing this agent to patients with hepatic impairment, and close monitoring of liver function is recommended.
1 source
- "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
Hypertriglyceridemia
ModerateIncreased levels of triglycerides have occurred in patients using perampanel. Care should be taken when prescribing this agent to patients with high triglycerides levels, and close monitoring of lipid profile is recommended during therapy.
1 source
- "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
Weight Gain
ModerateWeight gain has occurred with the use of perampanel. Care should be taken when prescribing this agent to patients predisposed to weight gain, and regular monitoring of weight is recommended.
1 source
- "Product Information. Fycompa (perampanel)." Eisai Inc (2012):