Although the simultaneous use of inductors CYP3A4 (eg
rifampicin, phenitoin, phenobarbital, carbamazepine, St Johns wort
(hypericum)) is studied, it is expected that simultaneous use of
potent CYP3A4 inductors can reduce rymonabantu concentration in
plasma and lower its effectiveness.
n vitro as rymonabant metabolized by CYP3A, and
amidohidrolazy (mainly in the liver). The simultaneous use of
CYP3A4 inhibitors will increase the duration rymonabantu.
Simultaneous application of CYP3A4 inductors should reduce the
duration rymonabantu.
Simultaneous application of orlistatom, ethanol or
lorazepamom not significantly affect the level rymonabantu in plasma.
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Although the simultaneous use of inductors CYP3A4 (eg
rifampicin, phenitoin, phenobarbital, carbamazepine, St Johns wort
(hypericum)) is studied, it is expected that simultaneous use of
potent CYP3A4 inductors can reduce rymonabantu concentration in
plasma and lower its effectiveness.
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Inhibitory effect on CYP2C8 in vivo is studied. However, in
vitro rymonabant had a weak inhibitory effect on CYP2C8. Assumed
that the ability rymonabantu inhibit CYP2C8 in vivo is low.
Rymonabant not inhibit or induce other CYP enzymes or
P-hlyukoproteyiny (P-gp) in vitro. This was confirmed clinically
in specific pilot studies using midazolamu (substrate for CYP
3A4), warfarin (substrate for CYP 2C9) and Digoxin (substrate of P-gp).
Pharmacokinetics in the equilibrium state of combined oral
contraceptives etynilu estradiol / levonorgestrel, not suffered
significant changes during simultaneous application of medication Akompliya.
Concurrent administration of ketoconazole (potent inhibitor
of CYP3A4) increased the area under the curve
"time-concentration in plasma» (AUC) rymonabantu to
104% (95% prediction interval: 40% -197%). A similar effect on the
expected duration of the simultaneous application of other
powerful inhibitors of CYP3A4. It is recommended to be cautious
while using the drug and potent inhibitors Akompliya CYP3A4 (eg
ketoconazole, itraconazole, ritonavir, telitromitsyn,
clarithromycin, nefazodon).
