Exsirox Drug Interactions

Metabolism/Transport effects: Substrate of UGT1A1; Inhibits CYP1A2 (moderate), CYP2C8 (moderate).
Agomelatine: CYP1A2 Inhibitors (Moderate) may increase the serum concentration of Agomelatine. Monitor therapy.
Aluminum hydroxide: Aluminum hydroxide may diminish the therapeutic effect of EXSIROX. Avoid combination.
Anticoagulants: Anticoagulants may enhance the adverse/toxic effect of EXSIROX. Specifically, the risk for GI ulceration/irritation or GI bleeding may be increased. Monitor therapy.
Bile acid sequestrants: Bile acid sequestrants may decrease the serum concentration of EXSIROX. Management: Avoid combination when possible; if the combination must be used, consider a 50% increase in initial EXSIROX dose, with monitoring of serum ferritin concentrations and clinical responses to guide further dosing. Consider therapy modification.
Bisphosphonate Derivatives: Bisphosphonate derivatives may enhance the adverse/toxic effect of EXSIROX. Specifically, the risk for GI ulceration/irritation or GI bleeding may be increased. Monitor therapy.
Corticosteroids: Corticosteroids may enhance the adverse/toxic effect of EXSIROX. Specifically, the risk for GI ulceration/irritation or GI bleeding may be increased. Exceptions: Beclomethasone (Nasal); Desonide; Dexamethasone (Ophthalmic); Difluprednate; Flunisolide (Nasal); Loteprednol; Mometasone (Nasal); Prednisolone (Ophthalmic); Triamcinolone (Nasal); Triamcinolone (Ophthalmic). Monitor therapy.
Corticosteroids (Systemic): Corticosteroids (Systemic) may enhance the adverse/toxic effect of EXSIROX. Specifically, the risk for GI ulceration/irritation or GI bleeding may be increased. Monitor therapy.
CYP1A2 Substrates: EXSIROX may increase the serum concentration of CYP1A2 Substrates. Monitor therapy.
CYP2C8 Substrates: EXSIROX may increase the serum concentration of CYP2C8 Substrates. Monitor therapy.
CYP3A4 Substrates: EXSIROX may decrease the serum concentration of CYP3A4 Substrates. Monitor therapy.
Fosphenytoin: Fosphenytoin may decrease the serum concentration of EXSIROX. Management: Avoid combination when possible; if the combination must be used, consider a 50% increase in initial EXSIROX dose, with monitoring of serum ferritin concentrations and clinical responses to guide further dosing. Consider therapy modification.
Nonsteroidal Anti-Inflammatory: Nonsteroidal Anti-Inflammatory may enhance the adverse/toxic effect of EXSIROX. Specifically, the risk for GI ulceration/irritation or GI bleeding may be increased. Monitor therapy.
Phenobarbital: Phenobarbital may decrease the serum concentration of EXSIROX. Management: Avoid combination when possible; if the combination must be used, consider a 50% increase in initial EXSIROX dose, with monitoring of serum ferritin concentrations and clinical responses to guide further dosing. Consider therapy modification.
Phenytoin: Phenytoin may decrease the serum concentration of EXSIROX. Management: Avoid combination when possible; if the combination must be used, consider a 50% increase in initial EXSIROX dose, with monitoring of serum ferritin concentrations and clinical responses to guide further dosing. Consider therapy modification.
Pirfenidone: CYP1A2 Inhibitors (Moderate) may increase the serum concentration of Pirfenidone. Management: Use any such combination with caution and close monitoring for Pirfenidone toxicity. Avoid the use of Pirfenidone with moderate CYP1A2 inhibitors whenever CYP2C9, 2C19, 2C6 or 2E1 is also inhibited (either by the CYP1A2 inhibitor or by a third drug). Consider therapy modification.
Repaglinide: EXSIROX may increase in the serum concentration of Repaglinide. Monitor therapy.
Rifampin: Rifampin may decrease the serum concentration of EXSIROX. Management: Avoid combination when possible; if the combination must be used, consider a 50% increase in initial EXSIROX dose, with monitoring of serum ferritin concentrations and clinical responses to guide further dosing. Consider therapy modification.
Ritonavir: Ritonavir may decrease the serum concentration of EXSIROX. Management: Avoid combination when possible; if the combination must be used, consider a 50% increase in initial EXSIROX dose, with monitoring of serum ferritin concentrations and clinical responses to guide further dosing. Consider therapy modification.
Theophylline: EXSIROX may increase in the serum concentration of Theophylline. Avoid combination.
Tizanidine: CYP1A2 Inhibitors (Moderate) may increase the serum concentration of Tizanidine. Management: If combined use cannot be avoided, initiate Tizanidine in adult at 2mg and increase in 2-4 mg increments based on patient response. Monitor for increased effects of Tizanidine, including adverse reaction. Avoid combination.