Astemizole Grapefruit juice

GRAPEFRUIT JUICE ASTEMIZOLE Likely T in cardiotoxicity. Likely t in Q-Tc interval Due to effects of grapefruit juice grapefruit juice on CYP isoenzymes and P-gp Do not co-administer as there are suitable alternatives that are less harmful, e.g. loratidine, cetrizine, desloratidine... 

Recent concerns with food products include grapefruit juice, which has been shown interact with many different medications through the CYP450 3A4 isoenzyme. This may increase the levels of medication such as cyclosporine, dihydropyridine calcium channel blockers, midazolam, triazolam, and astemizole. ... 

Clinically important, potentially hazardous interactions with abarelix, acenocoumarol, amisulpride, amprenavir, anisindione, anticoagulants, arsenic, astemizole, carbimazole, celiprolol, ciprofloxacin, dabigatran, degarelix, dicumarol, digoxin, diltiazem, enoxacin, fentanyl, fosamprenavir, gatifloxacin, grapefruit juice, lomefloxacin, methotrexate, moxifloxacin, nilotinib, norfloxacin, ofloxacin, oxprenolol, quinidine, quinolones, rifabutin, rifampin, rifapentine, ritonavir, simvastatin, sparfloxacin, sulpiride, tacrolimus, tipranavir, verapamil, warfarin, zuclopenthixol... 

Clinically important, potentially hazardous interactions with alfuzosin, alprazolam, amphotericin B, anisindione, antacids, aprepitant, astemizole, atorvastatin, bosentan, ciclesonide, cimetidine, clorazepate, conivaptan, cyproterone, dasatinib, dexamethasone, dicumarol, didanosine, eplerenone, erythromycin, ethotoin, fentanyl, fesoterodine, fosamprenavir, fosphenytoin, grapefruit juice, HMG-CoA reductase inhibitors, imatinib, ixabepilone, lapatinib, lopinavir, lovastatin, mephenytoin, methylprednisolone, micafungin, midazolam, nilotinib, pimozide, prednisolone, prednisone, quinidine, rifampin, rimonabant, rivaroxaban, sildenafil, silodosin, simvastatin, sirolimus, solifenacin, temsirolimus, terfenadine, tolvaptan, triazolam, vardenafil, vinblastine, vincristine, warfarin... 

Clinically important, potentially hazardous interactions with amiodarone, astemizole, bepridil, carbamazepine, chloroquine, cisapride, clarithromycin, dihydroergotamine, disopyramide, ergotamine, grapefruit juice, halofantrine, haloperidol, itraconazole, ketoconazole, methadone, moxifloxacin, phenobarbital, phenytoin, pimozide, procainamide, quinidine, rifampicin, ritonavir, sotalol, St John s wort, telithromycin, terfenadine, voriconazole... 

Clinically important, potentially hazardous interactions with amphetamines, aprepitant, astemizole, atazanavir, azithromycin, azole antifungals, clarithromycin, darunavir, dirithromycin, erythromycin, fluoxetine, fosamprenavir, grapefruit juice, imatinib, indinavir, itraconazole, ketoconazole, methylphenidate, nefazodone, nelfinavir, nilotinib, pemoline, phenothiazines, protease inhibitors, quinidine, ritonavir, saquinavir, sertraline, sparfloxacin, sulpiride, telithromycin, thioridazine, tipranavir, tricyclic antidepressants, troleandomycin, voriconazole, zileuton, ziprasidone... 

Clinically important, potentially hazardous interactions with amisulpride, aprepitant, astemizole, darunavir, devil s claw, erythromycin, grapefruit juice, nilotinib, roxithromycin, troleandomycin... 

Grapefruit juice raises terfenadine ievels, increasing the risk of QT interval prolongation and torsade de pointes arrhythmias. Grapefruit juice does not appear to alter the pharmacokinetics of astemizole and desloratadine. The absorption of fexofenadine is modestly reduced by grapefruit juice, orange juice and apple juice. 

In a study in 12 healthy subjects the steady-state pharmacokinetics of astemizole (30 mg daily ford days, then 10 mg daily for the next 20 days), were unaffected by 800 mL of grapefruit juice (given as 200 mL every... 

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