Reverse Drug Interactions

Summary: The information reported is based on binding affinity between SUGAMMADEX and other drugs, preclinical experiments, clinical studies and simulations of a pharmacokinetic-pharmacodynamic (PK-PD) model. Based on these considerations, no clinically significant pharmacodynamic interactions with other drugs are expected, with the exception of toremifene and hormonal contraceptives.
Interactions Potentially Affecting The Efficacy Of SUGAMMADEX: Toremifene: For toremifene, which has a relatively high binding affinity for Sugammadex and for which relatively high plasma concentrations might be present, some displacement of vecuronium or rocuronium from the complex with SUGAMMADEX could occur. The recovery to TOF ratio to 0.9 could therefore be delayed in patients who have received toremifene on the same day of surgery.
Interaction Potentially Affecting The Efficacy Of Hormonal Contraceptives: In vitro binding studies indicate that SUGAMMADEX may bind to progestogen, thereby decreasing progestogen exposure. Therefore, the administration of a bolus dose of SUGAMMADEX is considered to be equivalent to missing dose(s) of oral contraceptives containing an estrogen or progestogen. If an oral contraceptive is taken on the same day that SUGAMMADEX is administered, the patient must use an additional, non-hormonal contraceptive method or back-up method of contraception (such as condoms and spermicides) for the next 7 days.
In the case of non-oral hormonal contraceptives, the patient must use an additional, non-hormonal contraceptive method or back-up method of contraception (such as condoms and spermicides) for the next 7 days.
Interference With Laboratory Tests: SUGAMMADEX may interfere with the serum progesterone assay. Interference with this test was observed at Sugammadex plasma concentrations of 100 mcg/mL, which may be observed for up to 30 minutes after a 16 mg/kg dose.