Austedo interactions: Alcohol, medications, and other factors

Before you start treatment with Austedo, tell your doctor and pharmacist which prescription, over-the-counter (OTC), and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Austedo interacts with supplements, herbs, or vitamins, see the “Austedo and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Austedo. Keep in mind that this table doesn’t include all drugs that may interact with Austedo. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* For details about this interaction, see the “When to avoid Austedo” section below.
† Valerian root and melatonin are sometimes used as sleep aids. For details about their possible interactions with Austedo, see the “Austedo and other interactions” section below.
‡ For details about this interaction, see the “Drug interactions in depth” section below.

In some cases, factors or conditions could prevent your doctor from prescribing Austedo due to the risk of harm. These are known as contraindications. The contraindications of Austedo include:

Taking another vesicular monoamine transporter 2 inhibitor

Doctors typically will not prescribe Austedo in combination with other vesicular monoamine transporter 2 (VMAT2) inhibitors. Like Austedo, other VMAT2 inhibitors are prescribed for chorea in Huntington’s disease and tardive dyskinesia.

Austedo and other VMAT2 inhibitors work the same way in your body. Combining VMAT2 inhibitors could enhance the effect of either drug and increase the risk of side effects.

Other VMAT2 inhibitors that can interact with Austedo include tetrabenazine (Xenazine) and valbenazine (Ingrezza).

Before you start treatment with Austedo, tell your doctor if you already take a VMAT2 inhibitor. They can recommend the right treatment for your condition.

Taking a monoamine oxidase inhibitor

Doctors typically will not prescribe Austedo in combination with a type of antidepressant called a monoamine oxidase inhibitor (MAOI).

This is because taking Austedo with an MAOI could make either drug less effective. Austedo works by lowering the levels of certain brain chemicals, including dopamine. MAOIs work by increasing the levels of these chemicals. When taken together, neither drug may be as effective for treating your condition.

Below are a few examples of MAOIs that can interact with Austedo:

• isocarboxazid (Marplan)
• linezolid (Zyvox)
• methylene blue (ProvayBlue)
• phenelzine (Nardil)
• selegiline (Emsam)

Before you start treatment with Austedo, be sure to tell your doctor if you take an MAOI. They may have you stop taking the MAOI and wait at least 2 weeks before starting Austedo treatment. Likewise, after stopping Austedo treatment, your doctor may advise you to wait at least 2 weeks before starting MAOI treatment.

Having a liver problem

Doctors typically won’t prescribe Austedo for people with liver problems, such as liver failure. This is because having liver problems can prevent your body from breaking down Austedo as well as it should. As a result, the Austedo level could build up in your system and increase your risk of side effects from the drug.

If you have a liver problem, talk with your doctor before taking Austedo. They’ll likely prescribe a treatment other than Austedo for your condition.

Having depression or suicidal thoughts

Doctors typically won’t prescribe Austedo for people with Huntington’s disease who have depression or suicidal thoughts. (Austedo is approved to treat chorea in Huntington’s disease.)

This is because Austedo has a boxed warning about the risk of depression and suicidal thoughts or behaviors in people with Huntington’s disease. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Boxed warning” at the beginning of this article.

Note: Before you start treatment with Austedo, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Austedo.

Your doctor will likely recommend that you not drink alcohol while taking Austedo. They’ll also usually advise you not to take any prescription or OTC drugs that contain alcohol during Austedo treatment.

This is because drinking alcohol while taking the drug may worsen sleepiness as a side effect of Austedo and alcohol.

If you have concerns about avoiding alcohol while you’re taking Austedo, talk with your doctor before starting treatment.

Here’s a closer look at certain drug interactions of Austedo.

Benzodiazepines

Benzodiazepines are prescribed for several conditions, including anxiety and seizures.

Interaction result: Taking Austedo with a benzodiazepine can worsen sleepiness as a side effect of either drug.

Interaction explained: Both Austedo and benzodiazepines can cause sleepiness when taken individually. Taking these medications together may worsen this side effect.

Examples of benzodiazepines: Here are some benzodiazepines that may interact with Austedo:

• alprazolam (Xanax, Xanax XR)
• diazepam (Valium, Valtoco, others)
• lorazepam (Ativan, Loreev XR)
• midazolam (Nayzilam, Seizalam)
• triazolam (Halcion)

Steps you or your doctor may take: Before starting treatment with Austedo, tell your doctor if you’re taking a benzodiazepine. They can tell you whether it’s safe to take these medications together.

If your doctor prescribes Austedo with a benzodiazepine, they may advise you to avoid specific activities. These include driving, operating heavy machinery, or performing other tasks that require you to be alert. Your doctor may recommend avoiding these activities until you know how the combination of Austedo and benzodiazepines may affect you.

To learn more about Austedo and benzodiazepines, talk with your doctor or pharmacist.

Certain antihistamines

Antihistamines are used for many purposes. Examples include easing allergy symptoms and preventing motion sickness. Some antihistamines are available OTC, meaning you don’t need a prescription to purchase them.

Interaction result: Taking Austedo with certain antihistamines may raise the risk of some side effects or worsen them.

Interaction explained: Austedo and certain antihistamines may cause sleepiness when taken individually. This side effect may be worsened by taking these medications together.

In addition, both Austedo and certain antihistamines may cause irregular heart rhythm as a side effect. Taking these medications together may increase this risk.

Examples of antihistamine drugs: Here are some antihistamines that may interact with Austedo:

• cetirizine (Zyrtec)
• chlorpheniramine
• diphenhydramine (Benadryl)
• meclizine (Antivert, Dramamine, others)
• promethazine (Promethegan)

Steps you or your doctor may take: Before starting treatment with Austedo, tell your doctor if you’re taking an antihistamine. They’ll recommend whether it’s safe to take these medications together.

Before taking any OTC antihistamine with Austedo, talk with your doctor or pharmacist. They can advise you on which OTC antihistamines are safe to take with this drug. For example, it’s likely safe to take Austedo with fexofenadine (Allegra).

To learn more about Austedo and antihistamines, talk with your doctor or pharmacist.

Bupropion

Bupropion (Aplenzin, Wellbutrin XL, others) is prescribed for mental health conditions, including depression.

Interaction result: Taking Austedo with bupropion may increase the risk of side effects from Austedo.

Interaction explained: Bupropion may slow the activity of an enzyme (protein) that helps break down Austedo in your body. As a result, taking these drugs together can cause Austedo to build up in your system. This can lead to a high level of Austedo in your body, raising your risk of side effects.

Steps you or your doctor may take: Before starting treatment with Austedo, tell your doctor if you’re taking bupropion. They tell you whether it’s safe to take these medications together.

If your doctor prescribes Austedo with bupropion, they may prescribe a lower Austedo dosage than is typical. Doing so may help lower the risk of side effects from Austedo.

To learn more about Austedo and bupropion, talk with your doctor or pharmacist.

Austedo may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Austedo.

Austedo interactions with supplements

Austedo may interact with melatonin, which is a supplement used as a sleep aid. Taking Austedo with melatonin can increase the risk of sleepiness as a side effect of Austedo.

Before you start treatment with Austedo, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Austedo interactions with herbs

Austedo may interact with an herb called valerian root. Some people take this herb to ease symptoms of insomnia or anxiety. Taking valerian root during Austedo treatment could increase the risk of sleepiness as a side effect of Austedo.

If you take any valerian root supplements, talk with your doctor before starting Austedo treatment. They may advise you to stop taking the supplements.

Austedo and vitamins

There are no reports of vitamins interacting with Austedo. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Austedo.

Austedo and food

There are no reports of food interacting with Austedo. If you’d like to learn more about eating certain foods during treatment with Austedo, talk with your doctor.

Austedo and vaccines

Austedo isn’t known to interact with any vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Austedo and lab tests

Austedo isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

AUSTEDO INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Austedo. Taking Austedo with cannabis products could increase your risk of sleepiness as a side effect from Austedo or cannabis.

Before you start treatment with Austedo, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Austedo. Before you take this drug, be sure to talk with your doctor about your health history. Austedo may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Austedo include:

• Liver problems: If you have a liver problem, such as liver failure, your doctor will likely not prescribe Austedo. For more information, see the “When to avoid Austedo” section above.
• Irregular heart rhythm or factors that increase this risk: If you have an irregular heart rhythm or factors that increase this risk, your doctor may not prescribe Austedo. Examples of these factors include low blood levels of magnesium or potassium. You may have a higher risk of irregular heart rhythm as a side effect of Austedo. In such cases, your doctor may recommend a treatment other than Austedo for your condition.
• Allergic reaction: If you’ve had an allergic reaction to Austedo or any of its ingredients, your doctor will likely not prescribe Austedo. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding: It’s not known whether it’s safe to take Austedo while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Austedo may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Austedo. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: There haven’t been enough clinical trials to determine whether Austedo is safe to take while pregnant. Animal studies show that the drug may cause pregnancy loss. However, animal studies don’t always predict what will happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Austedo. They can advise you on the right treatment plan for you.
• Risk of depression or suicidal thoughts: Doctors typically won’t prescribe Austedo for people with Huntington’s disease who have depression or suicidal thoughts. In fact, Austedo has a boxed warning about the risk of depression and suicidal thoughts or behaviors in these people. This is a serious warning from the FDA. A boxed warning alerts doctors and patients about drug effects that may be dangerous. For details, see the boxed warning at the top of this article.

You can take certain steps to help prevent interactions with Austedo. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Austedo label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Austedo doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Austedo by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Austedo. These resources might help:

• Overview of Austedo: For a general overview of Austedo, you can see this article.
• Side effects: If you’re interested in the side effects of Austedo, see this article. Another option is to refer to the Austedo prescribing information.
• Dosage specifics: To learn about the dosage of Austedo, see this article.
• Cost: If you’d like to learn about Austedo and cost, see this article.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.