Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Carbamazepine, phenobarbital, phenytoin, and rifampin may speed up how quickly your liver processes apremilast and roflumilast.
What might happen:
Your apremilast or roflumilast may not work as well while you are taking these other medicines and for a few weeks after you stop taking them.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together or if you have them in the previous two weeks. Let your doctor know if your symptoms worsen. Your doctor may need to adjust your medicine.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Otezla (apremilast) US prescribing information. Celgene Corporation May, 2014.
2.Daxas (roflumilast) UK summary of product characteristics. Merck Sharp & Dohme Limited July, 2010.
3.Daliresp (roflumilast) US prescribing information. Forest Pharmaceutics, Inc. August, 2013.
4.Nassr N, Huennemeyer A, Herzog R, von Richter O, Hermann R, Koch M, Duffy K, Zech K, Lahu G. Effects of rifampicin on the pharmacokinetics of roflumilast and roflumilast N-oxide in healthy subjects. Br J Clin Pharmacol 2009 Oct;68(4):580-7.