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2046312 tn?1360379600

subxone and klonipin while doing tx?

I start tx in a few days, and I go see my doctor tomorrow. well last week my primary doctor put me on 1mg klonipin for my anxiety and I also have been taking suboxone for a while now which I forgot to tell my GI doc.  Can you take either of these while doing incivek, interferon and ribvirin? just wanted to see if anyone could tell me now, but i will definately ask my gi tomorrrow before starting tx.  thanks.
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Avatar universal
Yes the incivek will increase or decrease some drugs. I was taking 10 mg of valium 3 times a day. I pretty much slept the whole time I was on incivek. I found out later that the incevik increase the valium to 30 mg 3 times a day. I have to say when I came off the incivek I had the worse time with anxiety. So be very careful. Check with you doctor. Good luck....
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2046312 tn?1360379600
ok thank you very much!! i will talk to my doctor today about it but i appreciate your answers!
Helpful - 0
1840891 tn?1431547793
I can add a little bit from personal experience. I've taken Opana ER for quite a while due to severe chronic pain from spinal damage. I took it throughout triple tx with Incivek. My doctors had no idea it would interact with the Incivek and gave me no warning, but it most definitely did interact. The narcotics were much stronger and much longer lasting while I was on Incivek, such that after the first day or two I cut my dose of narcotics in half and did fine with that. If you get an interaction with both drugs at once it could be dangerously sedating, so be very careful even if your doctors approve of the combination.
Helpful - 0
1747881 tn?1546175878
Drug Interactions Results

Klonopin (clonazepam)
Suboxone (buprenorphine / naloxone)

Interactions between your selected drugs

clonazepam ↔ buprenorphine

Applies to: Klonopin (clonazepam), Suboxone (buprenorphine/naloxone)

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

http://www.drugs.com/interactions-check.php?drug_list=703-357,439-2040
Helpful - 0
1747881 tn?1546175878
Drug Interactions Results

Copegus (ribavirin)
Incivek (telaprevir)
Klonopin (clonazepam)
Pegasys (peginterferon alfa-2a)


Interactions between your selected drugs

clonazepam ↔ telaprevir

Applies to: Klonopin (clonazepam), Incivek (telaprevir)

MONITOR: Coadministration with telaprevir may increase the plasma concentrations of drugs that are metabolized by CYP450 3A4. The mechanism is decreased clearance due to inhibition of CYP450 3A4 activity by telaprevir.

MANAGEMENT: Caution is advised if telaprevir must be used concomitantly with medications that undergo metabolism by CYP450 3A4, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever telaprevir is added to or withdrawn from therapy.

No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.

http://www.drugs.com/interactions-check.php?drug_list=2009-1782,3328-15346,703-357,1806-1159

Drug Interactions Results

Copegus (ribavirin)
Incivek (telaprevir)
Pegasys (peginterferon alfa-2a)
Suboxone (buprenorphine / naloxone)

Interactions between your selected drugs

buprenorphine ↔ telaprevir

Applies to: Suboxone (buprenorphine/naloxone), Incivek (telaprevir)

MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations and pharmacologic effects of buprenorphine, which is partially metabolized (approximately 30%) by the isoenzyme. The interaction appears to be dependent, in part, on the route of administration of buprenorphine. When administered transdermally, buprenorphine peak plasma concentration (Cmax) and systemic exposure (AUC) were not significantly affected by ketoconazole, a potent CYP450 3A4 inhibitor. However, it was reported in another study that ketoconazole increased the Cmax and AUC of buprenorphine (route unspecified) by approximately 70% and 50%, respectively, and to a lesser extent, of the metabolite norbuprenorphine. The interaction has also been reported with atazanavir/ritonavir. A case series describes three patients who experienced excessive opiate effects of buprenorphine during concomitant antiretroviral therapy with atazanavir, ritonavir, and various nucleoside reverse transcriptase inhibitors. Two of the patients had been on their antiretroviral regimen for several months and reported doped-up feeling, dizziness, and feeling high following initiation of buprenorphine 8 mg/day. The dosage was reduced to 8 mg every other day. One was maintained on this dosage while the other had dosage increased up to 12 mg/day, whereupon he developed hypersomnolence but managed to maintain that dosage. The third patient had been inducted with buprenorphine and titrated to a stable dose of 14 mg/day for two days prior to beginning antiretroviral therapy. The next day, the patient complained of daytime somnolence and decreased mental functioning. His buprenorphine dosage was decreased to 8 mg/day, and he developed tolerance to the sedative effects within 7 days.

MANAGEMENT: Caution is advised if buprenorphine is prescribed in combination with a CYP450 3A4 inhibitor. Induction with buprenorphine should begin at a reduced dosage, and dosage escalation should occur more slowly to allow for assessment of opiate effects and development of patient tolerance. In patients who are already stabilized on buprenorphine, pharmacologic response and vital signs should be monitored more closely whenever a CYP450 3A4 inhibitor is added to or withdrawn from therapy, and the buprenorphine dosage adjusted as necessary. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities. Patients should seek medical attention if potential signs and symptoms of toxicity occur such as dizziness, confusion, fainting, extreme sedation, bradycardia, slow or difficult breathing, and shortness of breath.

No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.

http://www.drugs.com/interactions-check.php?drug_list=2009-1782,3328-15346,1806-1159,439-2040
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