on is used at lower doses, such as for post-operative nausea and vomiting, or when the oral formulation is used, the risk of QT prolongation is lower and caution is advised.
Lopinavir; Ritonavir: Due to the potential for QT prolongation and torsade de pointes (TdP), caution is advised when administering lopinavir; ritonavir with dolasetron. Lopinavir; ritonavir is associated with QT prolongation. Dolasetron has also been associated with a dose-dependent prolongation in the QT, PR, and QRS intervals on an electrocardiogram. Use of dolasetron injection for prevention of chemotherapy-induced nausea and vomiting is contraindicated because the risk of QT prolongation is higher with the doses needed for this indication. When the injectable formulation is used at lower doses (i.e., those approved for post-operative nausea and vomiting) or when the oral formulation is used, the risk of QT prolongation is lower and caution is advised. Additionally, lopinavir; ritonavir inhibits CYP3A4 and dolasetron is a CYP3A4 substrate. Coadministration may increase the serum concentrations of dolasetron. The use of ritonavir could result in QT prolongation. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with ritonavir include dolasetron.
Lumacaftor; Ivacaftor: Lumacaftor; ivacaftor may reduce the efficacy of dolasetron by decreasing its systemic exposure. Dolasetron is partially metabolized by CYP3A4. Lumacaftor is a strong inducer of CYP3A. When oral dolasetron was administered with rifampin, another strong CYP3A inducer, for 7 days, the AUC and Cmax of hydrodolasetron decreased by 28% and 17%, respectively. Of note, rifampin is also a weak inducer of CYP2D6, the primary substrate of dolasetron, but lumacaftor; ivacaftor does not affect CYP2D6.
Lumacaftor; Ivacaftor: Use caution when administering ivacaftor and dolasetron concurrently. Ivacaftor is an inhibitor of CYP3A and dolasetron is partially metabolized by CYP3A. Co-administration of ivacaftor with CYP3A substrates, such as dolasetron, can theoretically increase dolasetron exposure leading to increased or prolonged therapeutic effects and adverse events; however, the clinical impact of this has not yet been determined.
Maprotiline: Due to a possible risk for QT prolongation and torsade de pointes (TdP), dolasetron and lapatinib should be used together cautiously. Dolasetron has been associated with a dose-dependant prolongation in the QT, PR, and QRS intervals on an electrocardiogram. Use of dolasetron injection for the prevention of chemotherapy-induced nausea and vomiting is contraindicated because the risk of QT prolongation is higher with the doses required for this indication; when the injection is used at lower doses (i.e., those approved for post-operative nausea and vomiting) or when the oral formulation is used, the risk of QT prolongation is lower and caution is advised. Maprotiline has been reported to prolong the QT interval, particularly in overdose or with higher-dose prescription therapy (elevated serum concentrations). Cases of long QT syndrome and torsade de pointes (TdP) tachycardia have been described with maprotiline use, but rarely occur when the drug is used alone in normal prescribed doses and in the absence of other known risk factors for QT prolongation. Limited data are available regarding the safety of maprotiline in combination with other QT-prolonging drugs.
Mefloquine: Due to a possible risk for QT prolongation and t |
