Ein Paarvergleich findet Originalpassagen, die den anderen Wirkstoff wörtlich nennen. Aussagen gelten für das jeweilige Präparat und seine Formulierung. Klassenbegriffe und abweichende Synonyme können fehlen. Kein Treffer bedeutet nicht, dass keine Wechselwirkung besteht.
RxNorm 05-Oct-2026 · geprüft 2026-10-25 · 1009 Präparate · 54812 Quellenpassagen · 148 strukturierte Aussagen. Automatisch aktualisiert, ohne menschliche Freigabe.
Wechselwirkungen · Clopidogrel BGR (previously Zylagren)
Clopidogrel BGR 75 mg film-coated tablets · Abschnitt 4.5 · PDF-Seite 7
HOS-212212 · Präparat HOS-154848
As with other oral P2Y12 inhibitors, co-administration of opioid agonists has the potential to delay
and reduce the absorption of clopidogrel presumably because of slowed gastric emptying. The clinical
relevance is unknown. Consider the use of a parenteral antiplatelet agent in acute coronary syndrome
patients requiring co-administration of morphine or other opioid agonists.
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): morphine (HOS-086053) clopidogrel (HOS-087927)
Vollständigen Kontext in der EMA-Fachinformation lesen →Quellennachweis
Version 2020-03-11T02:00:00Z · SHA-256 2175bf409580f587aac82c2a36b07767e3fa81e6ce88fcb5b47bd52ea2f3eef2 · Passage 6db09d41ddaec0cbfc168345fec3c2bbbb8856a7b4b4ad1aa609b7db535de2f0 · Zeichen 8030–8407 im Abschnitt
Wechselwirkungen · Clopidogrel/Acetylsalicylic acid Zentiva (previously DuoCover)
Clopidogrel/Acetylsalicylic acid Zentiva 75 mg/75 mg film-coated tablets Clopidogrel/Acetylsalicylic acid Zentiva 75 mg/100 mg film-coated tablets · Abschnitt 4.5 · PDF-Seite 8
HOS-212265 · Präparat HOS-154856
As with other oral P2Y12 inhibitors, co-administration of opioid agonists has the potential to delay and
reduce the absorption of clopidogrel presumably because of slowed gastric emptying. The clinical
relevance is unknown. Consider the use of a parenteral antiplatelet agent in acute coronary syndrome
patients requiring co-administration of morphine or other opioid agonists.
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): morphine (HOS-086053)
Vollständigen Kontext in der EMA-Fachinformation lesen →Quellennachweis
Version 2019-11-13T14:36:00Z · SHA-256 fdf7b1939833e55bbc6a1c8732c66c147ac4404b0347a1c2e50406556ee7b8c0 · Passage ebf2daaa3ccadd0b427d7b3433d0cdf5012517969b4be9cd8953474eedf5cfdc · Zeichen 9636–10013 im Abschnitt
Wechselwirkungen · Clopidogrel Viatris (previously Clopidogrel Taw Pharma)
Clopidogrel Viatris 75 mg film-coated tablets · Abschnitt 4.5 · PDF-Seite 8–9
HOS-212543 · Präparat HOS-154922
8
As with other oral P2Y12 inhibitors, co-administration of opioid agonists has the potential to delay
and reduce the absorption of clopidogrel presumably because of slowed gastric emptying. The clinical
relevance is unknown. Consider the use of a parenteral antiplatelet agent in acute coronary syndrome
patients requiring co-administration of morphine or other opioid agonists.
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): morphine (HOS-086053) clopidogrel (HOS-087927)
Vollständigen Kontext in der EMA-Fachinformation lesen →Quellennachweis
Version 2025-12-12T14:50:00Z · SHA-256 e9e7d4f8970d3988a1ba7d9aaf346cccae34503164616a23f43de2932801e6e6 · Passage 6bc08f0aa9e3b16e5bc7cd572703ce6c95dca83bc2849ca0b9ff51751fe8f5af · Zeichen 8656–9036 im Abschnitt
Wechselwirkungen · Topotecan Hospira
Topotecan Hospira 4 mg/4 ml concentrate for solution for infusion · Abschnitt 4.5 · PDF-Seite 5
HOS-122944 · Präparat HOS-095615
Topotecan does not inhibit human P450 enzymes (see section 5.2). In a population study using the
intravenous route, the co-administration of granisetron, ondansetron, morphine or corticosteroids did
not appear to have a significant effect on the pharmacokinetics of total topotecan (active and inactive
form).
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): granisetron (HOS-086051) morphine (HOS-086053) ondansetron (HOS-086052)
Vollständigen Kontext in der EMA-Fachinformation lesen →Quellennachweis
Version 2026-03-31T11:50:00Z · SHA-256 51b338badc1d33edf5bf2700d056d46275447e6a3f83ae2173852608cc281250 · Passage d27e1b5b61b19b13cd540fbd8eb707ba48108ab348d5bd6e06f7ae0a98a579aa · Zeichen 75–384 im Abschnitt
Wechselwirkungen · Brilique
Brilique 60 mg film-coated tablets · Abschnitt 4.5 · PDF-Seite 7
HOS-123521 · Präparat HOS-095701
A delayed and decreased exposure to oral P2Y12 inhibitors, including ticagrelor and its active
metabolite, has been observed in patients with ACS treated with morphine (35% reduction in
ticagrelor exposure). This interaction may be related to reduced gastrointestinal motility and apply to
other opioids. The clinical relevance is unknown, but data indicate the potential for reduced ticagrelor
efficacy in patients co-administered ticagrelor and morphine. In patients with ACS, in whom
morphine cannot be withheld and fast P2Y12 inhibition is deemed crucial, the use of a parenteral
P2Y12 inhibitor may be considered.
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): morphine (HOS-086053)
Vollständigen Kontext in der EMA-Fachinformation lesen →Quellennachweis
Version 2026-08-18T10:59:00Z · SHA-256 f815638059a70571d33a6ddc4107523f2ae567aafc2b20551ad4a9b0fb2f2aca · Passage 11a97bb677927dd465b2ab46146ed12cf09d21aea78dff4a1acaef2269b53e34 · Zeichen 3204–3822 im Abschnitt
Wechselwirkungen · Brilique
Brilique 90 mg film-coated tablets · Abschnitt 4.5 · PDF-Seite 29
HOS-123581 · Präparat HOS-095701
A delayed and decreased exposure to oral P2Y12 inhibitors, including ticagrelor and its active
metabolite, has been observed in patients with ACS treated with morphine (35% reduction in
ticagrelor exposure). This interaction may be related to reduced gastrointestinal motility and apply to
other opioids. The clinical relevance is unknown, but data indicate the potential for reduced ticagrelor
efficacy in patients co-administered ticagrelor and morphine. In patients with ACS, in whom
morphine cannot be withheld and fast P2Y12 inhibition is deemed crucial, the use of a parenteral
P2Y12 inhibitor may be considered.
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): morphine (HOS-086053)
Vollständigen Kontext in der EMA-Fachinformation lesen →Quellennachweis
Version 2026-08-18T10:59:00Z · SHA-256 f815638059a70571d33a6ddc4107523f2ae567aafc2b20551ad4a9b0fb2f2aca · Passage 11a97bb677927dd465b2ab46146ed12cf09d21aea78dff4a1acaef2269b53e34 · Zeichen 3206–3824 im Abschnitt
Wechselwirkungen · Brilique
Brilique 90 mg orodispersible tablets · Abschnitt 4.5 · PDF-Seite 52
HOS-123637 · Präparat HOS-095701
A delayed and decreased exposure to oral P2Y12 inhibitors, including ticagrelor and its active
metabolite, has been observed in patients with ACS treated with morphine (35% reduction in
ticagrelor exposure). This interaction may be related to reduced gastrointestinal motility and apply to
other opioids. The clinical relevance is unknown, but data indicate the potential for reduced ticagrelor
efficacy in patients co-administered ticagrelor and morphine. In patients with ACS, in whom
morphine cannot be withheld and fast P2Y12 inhibition is deemed crucial, the use of a parenteral
P2Y12 inhibitor may be considered.
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): morphine (HOS-086053)
Vollständigen Kontext in der EMA-Fachinformation lesen →Quellennachweis
Version 2026-08-18T10:59:00Z · SHA-256 f815638059a70571d33a6ddc4107523f2ae567aafc2b20551ad4a9b0fb2f2aca · Passage 11a97bb677927dd465b2ab46146ed12cf09d21aea78dff4a1acaef2269b53e34 · Zeichen 3204–3822 im Abschnitt
Wechselwirkungen · Potactasol
Potactasol 1 mg powder for concentrate for solution for infusion Potactasol 4 mg powder for concentrate for solution for infusion · Abschnitt 4.5 · PDF-Seite 5
HOS-214131 · Präparat HOS-155272
Topotecan does not inhibit human P450 enzymes (see section 5.2). In a population study using the
intravenous route, the co-administration of granisetron, ondansetron, morphine or corticosteroids did
not appear to have a significant effect on the pharmacokinetics of total topotecan (active and inactive
form).
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): granisetron (HOS-086051) morphine (HOS-086053) ondansetron (HOS-086052)
Vollständigen Kontext in der EMA-Fachinformation lesen →Quellennachweis
Version 2025-01-20T15:29:00Z · SHA-256 c68b2e48aa64589388567936c88f944172f5a013496cba099e51d86c2816bef9 · Passage d27e1b5b61b19b13cd540fbd8eb707ba48108ab348d5bd6e06f7ae0a98a579aa · Zeichen 75–384 im Abschnitt
Wechselwirkungen · Xalkori
XALKORI 200 mg hard capsules XALKORI 250 mg hard capsules XALKORI 20 mg granules in capsules for opening XALKORI 50 mg granules in capsules for opening XALKORI 150 mg granules in capsules for opening · Abschnitt 4.5 · PDF-Seite 16
HOS-126284 · Präparat HOS-096239
In vitro studies indicated that crizotinib is a weak inhibitor of uridine diphosphate
glucuronosyltransferase (UGT)1A1 and UGT2B7. Therefore, crizotinib may have the potential to
increase plasma concentrations of coadministered medicinal products that are metabolised
predominantly by UGT1A1 (e.g., raltegravir, irinotecan) or UGT2B7 (e.g., morphine, naloxone).
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): morphine (HOS-086053) naloxone (HOS-109490) raltegravir (HOS-086187) uridine (HOS-085192) irinotecan (HOS-112102)
Vollständigen Kontext in der EMA-Fachinformation lesen →Quellennachweis
Version 2025-09-17T11:44:00Z · SHA-256 ef70dd9e8f617f709767e5bd4c7044eb23893a7ac40281434ebfa2fb8fb4e3d5 · Passage f7028ed14c6551ed5f1262b416ee82afd27a4ab519d19452d601e7cbc808952b · Zeichen 5362–5723 im Abschnitt
Wechselwirkungen · Akynzeo
Akynzeo 300 mg/0.5 mg hard capsules · Abschnitt 4.5 · PDF-Seite 6
HOS-130705 · Präparat HOS-096947
Netupitant/palonosetron capsules are unlikely to interact with medicinal products which are P-gp
substrates. Netupitant is not a substrate for P-gp. When netupitant was administered on Day 8 of a
12-day regimen of digoxin, no changes in digoxin pharmacokinetics were observed.
Inhibition of the efflux transported BCRP and glucuronidation isozyme UGT2B7 by netupitant and
its metabolites is unlikely and, if it occurs, of scarce clinical relevance.
In vitro data shows that netupitant inhibits UGT2B7, the magnitude of such an effect in the clinical
setting is not established. Caution is recommended when netupitant is combined with an oral
substrate of this enzyme (e.g.zidovudine, valproic acid, morphine).
In vitro data suggests that netupitant inhibits the efflux of transporter BCRP. The clinical relevance
of this effect is not established.
In vitro data show that netupitant is a P-gp inhibitor. In a study performed in healthy volunteers,
netupitant does not affect the exposure of digoxin, a P-gp substrate, whereas it increases its Cmax by
1.09 fold [90%CI 0.9-1.31]. It is not excluded that this effect may be more marked, and then clinically
relevant, in cancer patients, notably those having abnormal renal function. Therefore, caution is
recommended when netupitant is combined with digoxin or with other P-gp substrates such as
dabigatran, or colchicine.
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): valproic acid (HOS-088515) digoxin (HOS-086172) dabigatran (HOS-112096) morphine (HOS-086053) zidovudine (HOS-085837) colchicine (HOS-086147)
Vollständigen Kontext in der EMA-Fachinformation lesen →Quellennachweis
Version 2026-08-25T11:52:00Z · SHA-256 d3ff78e9e4d5b08bc98e527fab724082b02f5be1899a4d4f9c683d723854e46c · Passage 96b7ee6eabe5208fbc56455ff673b439029e4001003dd7cdd5c63d4eabcfef30 · Zeichen 5376–6746 im Abschnitt
Wechselwirkungen · Akynzeo
Akynzeo 235 mg/0.25 mg powder for concentrate for solution for infusion · Abschnitt 4.5 · PDF-Seite 22
HOS-130744 · Präparat HOS-096947
Fosnetupitant/palonosetron powder for concentrate for solution for infusion is unlikely to interact with
medicinal products which are P-gp substrates. Netupitant is not a substrate for P-gp. When netupitant
was administered on Day 8 of a 12-day regimen of digoxin, no changes in digoxin pharmacokinetics
were observed.
Inhibition of the efflux transporter BCRP by fosenetupitant netupitant and its metabolites is unlikely
and, if it occurs, of scarce clinical relevance.
In vitro data shows that fosnetupitant inhibits UGT2B7 / UGT2B15 and netupitant inhibits UGT2B7,
the magnitude of such an effect in the clinical setting is not established. Caution is therefore
recommended when netupitant and fosnetupitant is combined with an oral substrate of this enzyme
(e.g. zidovudine, valproic acid, morphine).
In vitro data suggests that netupitant inhibits the efflux of transporter BCRP. The clinical relevance of
this effect is not established.
In vitro data show that netupitant is a P-gp inhibitor. In a study performed in healthy volunteers,
netupitant does not affect the exposure of digoxin, a P-gp substrate, whereas it increases its Cmax by
1.09 fold [90%CI 0.9-1.31]. It is not excluded that this effect may be more marked, and then clinically
relevant, in cancer patients, notably those having abnormal renal function. Therefore, caution is
recommended when netupitant is combined with digoxin or with other P-gp substrates such as
dabigatran, or colchicine.
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): valproic acid (HOS-088515) digoxin (HOS-086172) dabigatran (HOS-112096) morphine (HOS-086053) fosnetupitant (HOS-130728) zidovudine (HOS-085837) colchicine (HOS-086147)
Vollständigen Kontext in der EMA-Fachinformation lesen →Quellennachweis
Version 2026-08-25T11:52:00Z · SHA-256 d3ff78e9e4d5b08bc98e527fab724082b02f5be1899a4d4f9c683d723854e46c · Passage 5599ee427a1e50bd2272fe198378f2c70e90fb72bcd0d5255d25c484c7630b39 · Zeichen 5421–6886 im Abschnitt
Wechselwirkungen · Akynzeo
Akynzeo 235 mg/0.25 mg concentrate for solution for infusion · Abschnitt 4.5 · PDF-Seite 40
HOS-130786 · Präparat HOS-096947
Additional interactions
Fosnetupitant/palonosetron concentrate for solution for infusion is unlikely to interact with medicinal
products which are P-gp substrates. Netupitant is not a substrate for P-gp. When netupitant was
administered on Day 8 of a 12-day regimen of digoxin, no changes in digoxin pharmacokinetics were
observed.
Inhibition of the efflux transporter BCRP by fosenetupitant, netupitant and its metabolites is unlikely
and, if it occurs, of scarce clinical relevance.
In vitro data shows that fosnetupitant inhibits UGT2B7 / UGT2B15 and netupitant inhibits UGT2B7,
the magnitude of such an effect in the clinical setting is not established. Caution is therefore
recommended when netupitant and fosnetupitant is combined with an oral substrate of this enzyme
(e.g. zidovudine, valproic acid, morphine).
In vitro data suggests that netupitant inhibits the efflux of transporter BCRP. The clinical relevance of
this effect is not established.
In vitro data show that netupitant is a P-gp inhibitor. In a study performed in healthy volunteers,
netupitant does not affect the exposure of digoxin, a P-gp substrate, whereas it increases its Cmax by
1.09 fold [90%CI 0.9-1.31]. It is not excluded that this effect may be more marked, and then clinically
relevant, in cancer patients, notably those having abnormal renal function. Therefore, caution is
recommended when netupitant is combined with digoxin or with other P-gp substrates such as
dabigatran, or colchicine.
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): valproic acid (HOS-088515) digoxin (HOS-086172) dabigatran (HOS-112096) morphine (HOS-086053) fosnetupitant (HOS-130728) zidovudine (HOS-085837) colchicine (HOS-086147)
Vollständigen Kontext in der EMA-Fachinformation lesen →Quellennachweis
Version 2026-08-25T11:52:00Z · SHA-256 d3ff78e9e4d5b08bc98e527fab724082b02f5be1899a4d4f9c683d723854e46c · Passage 8c215b1fbfe8f1f9dbaf112d918c68f8d01887bfa8a5614b7eb096350ae2d47a · Zeichen 5397–6876 im Abschnitt
Wechselwirkungen · Akynzeo
Akynzeo 300 mg/0.5 mg oral suspension in sachet · Abschnitt 4.5 · PDF-Seite 57
HOS-130825 · Präparat HOS-096947
In vitro data shows that netupitant inhibits UGT2B7, the magnitude of such an effect in the clinical
setting is not established. Caution is recommended when netupitant is combined with an oral
substrate of this enzyme (e.g.zidovudine, valproic acid, morphine).
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): valproic acid (HOS-088515) morphine (HOS-086053) zidovudine (HOS-085837)
Vollständigen Kontext in der EMA-Fachinformation lesen →Quellennachweis
Version 2026-08-25T11:52:00Z · SHA-256 d3ff78e9e4d5b08bc98e527fab724082b02f5be1899a4d4f9c683d723854e46c · Passage 1e5c1a5d2728ea8c998200ac04c6958893ed6e30956cc333e5d79dd3aa17397a · Zeichen 5817–6077 im Abschnitt
Wechselwirkungen · Rxulti
RXULTI 0.25 mg film-coated tablets RXULTI 0.5 mg film-coated tablets RXULTI 1 mg film-coated tablets RXULTI 2 mg film-coated tablets RXULTI 3 mg film-coated tablets RXULTI 4 mg film-coated tablets · Abschnitt 4.5 · PDF-Seite 8
HOS-132044 · Präparat HOS-097184
Pharmacodynamic interactions
No information on pharmacodynamic interactions of brexpiprazole is available at present. Caution
should be exercised when prescribing other medicinal products concomitantly. Given the primary
Central Nervous System (CNS) effects of brexpiprazole, caution should be used when brexpiprazole is
taken in combination with alcohol or other CNS medicinal products with overlapping adverse
reactions such as opiates like codeine or morphine (see section 4.8).
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): codeine (HOS-090544) morphine (HOS-086053)
Vollständigen Kontext in der EMA-Fachinformation lesen →Quellennachweis
Version 2026-03-12T14:38:00Z · SHA-256 d060cc667cc18af4e73efacd249c6f69ccb808c8be005b26cc608ba465837472 · Passage 0f7d3d5a1aa58d6b9401d8452d2c66f019fe61de766cf5586e95e7c6dff873f7 · Zeichen 2987–3468 im Abschnitt
Wechselwirkungen · Zubsolv
Zubsolv 0.7 mg/0.18 mg sublingual tablets Zubsolv 1.4 mg/0.36 mg sublingual tablets Zubsolv 2.9 mg/0.71 mg sublingual tablets Zubsolv 5.7 mg/1.4 mg sublingual tablets Zubsolv 8.6 mg/2.1 mg sublingual tablets Zubsolv 11.4 mg/2.9 mg sublingual tablets · Abschnitt 4.5 · PDF-Seite 9–10
HOS-138581 · Präparat HOS-098216
Zubsolv should be used cautiously when co-administered with:
• Sedatives such as benzodiazepines or related medicinal products
The concomitant use of opioids with sedative medicinal products such as benzodiazepines or
related medicinal products increases the risk of sedation, respiratory depression, coma and
death because of additive CNS depressant effect. The dose and duration of concomitant use
of sedative medicinal products should be limited (see section 4.4). Patients should be
warned that it is extremely dangerous to self-administer non-prescribed benzodiazepines
while taking this medicinal product and should also be cautioned to use benzodiazepines
concurrently with this medicinal product only as directed by their physician (see
section 4.4).
• The concomitant use of Zubsolv with gabapentinoids (gabapentin and pregabalin) may
result in respiratory depression, hypotension, profound sedation, coma or death (see section
4.4).
• Other central nervous system depressants, other opioid derivatives (e.g. methadone,
analgesics and antitussives), certain antidepressants, sedative H1-receptor antagonists,
barbiturates, anxiolytics other than benzodiazepines, neuroleptics, clonidine and related
substances: these combinations increase central nervous system depression. The reduced
level of alertness can make driving and using machines hazardous.
• Furthermore, adequate analgesia may be difficult to achieve when administering a full opioid
agonist in patients receiving buprenorphine/naloxone. Therefore the potential to overdose
with a full agonist exists, especially when attempting to overcome buprenorphine partial
agonist effects, or when buprenorphine plasma levels are declining
• Serotonergic medicinal products, such as MAO inhibitors, selective serotonin re-uptake
inhibitors (SSRIs), serotonin norepinephrine re-uptake inhibitors (SNRIs) or tricyclic
antidepressants as the risk of serotonin syndrome, a potentially life-threatening condition, is
increased (see section 4.4)
• naltrexone and nalmefene are opioid antagonists that can block the pharmacological effects
of buprenorphine. Co-administration during buprenorphine/naloxone treatment is
9
contraindicated due to the potentially dangerous interaction that may precipitate a sudden
onset of prolonged and intense opioid withdrawal symptoms (see section 4.3).
• CYP3A4 inhibitors: an interaction study of buprenorphine with ketoconazole (a potent
inhibitor of CYP3A4) resulted in increased Cmax and AUC (area under the curve) of
buprenorphine (approximately 50 % and 70 % respectively) and, to a lesser extent, of
norbuprenorphine Patients receiving Zubsolv should be closely monitored, and may require
dose-reduction if combined with potent CYP3A4 inhibitors (e.g. protease inhibitors like
ritonavir, nelfinavir or indinavir or azole antifungals such as ketoconazole or itraconazole,
macrolide antibiotics).
• CYP3A4 inducers: Concomitant use of CYP3A4 inducers with buprenorphine may
decrease buprenorphine plasma concentrations, potentially resulting in sub-optimal
treatment of opioid dependence with buprenorphine. It is recommended that patients
receiving buprenorphine/naloxone should be closely monitored if inducers (e.g.
phenobarbital, carbamazepine, phenytoin, rifampicin) are co-administered. The dose of
buprenorphine or the CYP3A4 inducer may need to be adjusted accordingly.
• The concomitant use of monoamine oxidase inhibitors (MAOI) might produce
exaggeration of the effects of opioids, based on experience with morphine.
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): indinavir (HOS-084518) pregabalin (HOS-112893) norepinephrine (HOS-090547) nelfinavir (HOS-084520) methadone (HOS-086198) protease (HOS-085623) phenobarbital (HOS-085617) ketoconazole (HOS-084513) clonidine (HOS-088594) carbamazepine (HOS-085618) naltrexone (HOS-115836) nalmefene (HOS-115837) morphine (HOS-086053) gabapentin (HOS-090745) serotonin (HOS-085477) itraconazole (HOS-084516) ritonavir (HOS-084521) phenytoin (HOS-084531)
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Version 2025-12-08T09:49:00Z · SHA-256 5abf2fbb0a7fd36ed1be04f576c9d6b4a021a25a707c692fa21b326376a4f2b5 · Passage 36507a34d513c06aeda586e977de80135455da379f00364e466d3a649d3e2c11 · Zeichen 232–4044 im Abschnitt
Wechselwirkungen · Buvidal
Buvidal 8 mg prolonged-release solution for injection Buvidal 16 mg prolonged-release solution for injection Buvidal 24 mg prolonged-release solution for injection Buvidal 32 mg prolonged-release solution for injection · Abschnitt 4.5 · PDF-Seite 8–9
HOS-140312 · Präparat HOS-098498
8
expected to have less effects on buprenorphine metabolism when co-administered with
Buvidal as compared to when co-administered with sublingual buprenorphine. When
switching from sublingual buprenorphine to Buvidal, patients may need to be monitored
to ensure plasma buprenorphine levels are adequate.
Patients already on Buvidal who start treatment with CYP3A4 inhibitors should be
treated with weekly Buvidal and be monitored for signs and symptoms of overtreatment.
Conversely, if a patient who is concomitantly treated with Buvidal and a CYP3A4
inhibitor stops treatment with the CYP3A4 inhibitor, the patient should be monitored for
symptoms of withdrawal (see section 4.4).
• CYP3A4 inducers may induce the metabolism of buprenorphine resulting in decreased
buprenorphine levels. Buvidal avoids first-pass effects and CYP3A4 inducers (e.g.
phenobarbital, carbamazepine, phenytoin or rifampicin) are expected to have less effects
on buprenorphine metabolism when co-administered with Buvidal as compared to when
co-administered with sublingual buprenorphine. When switching from sublingual
buprenorphine to Buvidal, patients may need to be monitored to ensure plasma
buprenorphine levels are adequate. Patients already on Buvidal who start treatment with
CYP3A4 inducers should be treated with weekly Buvidal and be monitored for signs and
symptoms of withdrawal. Conversely, if a patient who is concomitantly treated with
Buvidal and a CYP3A4 inducer stops treatment with the CYP3A4 inducer, the patient
should be monitored for symptoms of overtreatment.
• UGT1A1 inhibitors may affect the systemic exposure of buprenorphine.
• monoamine oxidase inhibitors (MAOI): Possible exacerbation of the opioids effects, based on
experience with morphine.
• concomitant administration of buprenorphine with anticholinergics or medications with
anticholinergic activity (e.g. tricyclic antidepressants, antihistamines, antipsychotics, muscle
relaxants, anti-parkinson drugs) may result in increased anticholinergic adverse effects.
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): phenobarbital (HOS-085617) carbamazepine (HOS-085618) morphine (HOS-086053) phenytoin (HOS-084531)
Vollständigen Kontext in der EMA-Fachinformation lesen →Quellennachweis
Version 2025-03-21T17:42:00Z · SHA-256 1ad9ce13109b545d01c45ffd56cec5dc90c2b7294f4e2ae1f7e5e985c1a064eb · Passage cd7134e4c4ec0886c5912360fd53b900c55236e6232700e36d9ff527b586198c · Zeichen 3636–5965 im Abschnitt
Wechselwirkungen · Buvidal
Buvidal 64 mg prolonged-release solution for injection Buvidal 96 mg prolonged-release solution for injection Buvidal 128 mg prolonged-release solution for injection Buvidal 160 mg prolonged-release solution for injection · Abschnitt 4.5 · PDF-Seite 24–25
HOS-140340 · Präparat HOS-098498
24
inhibitor stops treatment with the CYP3A4 inhibitor, the patient should be monitored for
symptoms of withdrawal (see section 4.4).
• CYP3A4 inducers may induce the metabolism of buprenorphine resulting in decreased
buprenorphine levels. Buvidal avoids first-pass effects and CYP3A4 inducers (e.g.
phenobarbital, carbamazepine, phenytoin or rifampicin) are expected to have less effects
on buprenorphine metabolism when co-administered with Buvidal as compared to when
co-administered with sublingual buprenorphine. When switching from sublingual
buprenorphine to Buvidal, patients may need to be monitored to ensure plasma
buprenorphine levels are adequate. Patients already on Buvidal who start treatment with
CYP3A4 inducers should be treated with weekly Buvidal and be monitored for signs and
symptoms of withdrawal. Conversely, if a patient who is concomitantly treated with
Buvidal and a CYP3A4 inducer stops treatment with the CYP3A4 inducer, the patient
should be monitored for symptoms of overtreatment.
• UGT1A1 inhibitors may affect the systemic exposure of buprenorphine.
• monoamine oxidase inhibitors (MAOI): Possible exacerbation of the opioids effects, based on
experience with morphine.
• concomitant administration of buprenorphine with anticholinergics or medications with
anticholinergic activity (e.g. tricyclic antidepressants, antihistamines, antipsychotics, muscle
relaxants, anti-parkinson drugs) may result in increased anticholinergic adverse effects.
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): phenobarbital (HOS-085617) carbamazepine (HOS-085618) morphine (HOS-086053) phenytoin (HOS-084531)
Vollständigen Kontext in der EMA-Fachinformation lesen →Quellennachweis
Version 2025-03-21T17:42:00Z · SHA-256 1ad9ce13109b545d01c45ffd56cec5dc90c2b7294f4e2ae1f7e5e985c1a064eb · Passage 5952306464469e55f6b80443c2c369676672268e5a801ffbed9600ed61e74ace · Zeichen 4269–5959 im Abschnitt
Wechselwirkungen · Ozawade
Ozawade 4.5 mg film-coated tablets Ozawade 18 mg film-coated tablets · Abschnitt 4.5 · PDF-Seite 6
HOS-144429 · Präparat HOS-099178
Medicinal products that pitolisant may affect metabolism
- CYP3A4 and CYP2B6 substrates
A clinical induction study showed that pitolisant is a weak inducer of CYP3A (0.2-fold reduction in
midazolam exposure). Therefore, the combination of pitolisant with substrates of CYP3A4 and having
a narrow therapeutic margin (e.g. immunosuppressants, docetaxel, kinase inhibitors, cisapride,
pimozide, halofantrine) should be avoided (see section 4.4). With other CYP3A4, CYP2C (e.g.
repaglinide, phenytoin, warfarin), P-gp (e.g. dabigatran, digoxin) and UGT (e.g. morphine,
paracetamol, irinotecan) substrates, caution should be made with a clinical monitoring of their
efficacy.
Pitolisant might decrease the exposure to oral contraceptives and an additional further reliable
contraceptive method should be used (see section 4.6).
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
RxNorm-Namen im Text (wörtliche Treffer, Rolle nicht bewertet): cisapride (HOS-085610) halofantrine (HOS-085606) digoxin (HOS-086172) dabigatran (HOS-112096) morphine (HOS-086053) docetaxel (HOS-084505) pimozide (HOS-085600) irinotecan (HOS-112102) phenytoin (HOS-084531) warfarin (HOS-085950) repaglinide (HOS-086935) midazolam (HOS-086167)
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Version 2026-08-06T11:36:00Z · SHA-256 6132349ff4302f19688e606b853696608a2e68d699ec2c7f66e494671825abac · Passage 2faea55b7538b79c18eaf1c0c29bd80881928294c47c04e3ed7cbb5671f75d84 · Zeichen 4673–5500 im Abschnitt
This product uses publicly available data from the U.S. National Library of Medicine (NLM), National Institutes of Health, Department of Health and Human Services; NLM is not responsible for the product and does not endorse or recommend this or any other product.