Multiple drugs have the potential to interact with TRINTELLIX, including prescription and over-the-counter medicines, vitamins, and herbal supplements. TRINTELLIX and some drugs should not be taken concomitantly as co-administration may lead to serious side effects or decreases in efficacy.1
See below for clinically important interactions with TRINTELLIX.1
NOTE: this is not an exhaustive list of TRINTELLIX drug interactions. Please see the Full Prescribing Information for further information.
Monoamine Oxidase Inhibitors (MAOIs)
Clinical Impact | The concomitant use of SSRIs and SNRIs including TRINTELLIX with MAOIs increases the risk of serotonin syndrome.
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Intervention | Concomitant use of TRINTELLIX is contraindicated:
- With an MAOI intended to treat psychiatric disorders or within 21 days of stopping treatment with TRINTELLIX.
- Within 14 days of stopping an MAOI intended to treat psychiatric disorders.
- In a patient who is being treated with linezolid or intravenous methylene blue.
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Examples | selegiline, tranylcypromine, isocarboxazid, phenelzine, linezolid, methylene blue
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Other Serotonergic Drugs
Clinical Impact | Concomitant use of TRINTELLIX with other serotonergic drugs increases the risk of serotonin syndrome.
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Intervention | Monitor for symptoms of serotonin syndrome when TRINTELLIX is used concomitantly with other drugs that may affect the serotonergic neurotransmitter systems. If serotonin syndrome occurs, consider discontinuation of TRINTELLIX and/or concomitant serotonergic drugs.
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Examples | Other SNRIs, SSRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, and St. John's Wort
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Strong Inhibitors of CYP2D6
Clinical Impact | Concomitant use of TRINTELLIX with strong CYP2D6 inhibitors increases plasma concentrations of vortioxetine.
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Intervention | Reduce TRINTELLIX dose by half when a strong CYP2D6 inhibitor is coadministered.
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Examples | bupropion, fluoxetine, paroxetine, quinidine
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Strong CYP Inducers
Clinical Impact | Concomitant use of TRINTELLIX with strong CYP inducer decreases plasma concentrations of vortioxetine.
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Intervention | Consider increasing the TRINTELLIX dose when a strong CYP inducer is coadministered. The maximum dose is not recommended to exceed three times the original dose.
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Examples | rifampin, carbamazepine, phenytoin
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Drugs that interfere with Hemostasis (antiplatlet agents and anticoagulants)
Clinical Impact | Concomitant use of TRINTELLIX with an antiplatelet or anticoagulant drug may potentiate the risk of bleeding.
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Intervention | Inform patients of the increased risk of bleeding associated with the concomitant use of TRINTELLIX and antiplatelet agents and anticoagulants. For patients taking warfarin, carefully monitor the international normalized ratio.
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Examples | aspirin, clopidogrel, heparin, warfarin
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Drugs Highly Bound to Plasma Protein
Clinical Impact | TRINTELLIX is highly bound to plasma protein. The concomitant use of TRINTELLIX with another drug that is highly bound to plasma protein may increase free concentrations of TRINTELLIX or other tightly-bound drugs in plasma.
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Intervention | Monitor for adverse reactions and reduce dosage of TRINTELLIX or other protein bound drugs as warranted.
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Examples | warfarin
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