Litfulo interactions: Alcohol, medications, and other factors

Before you start treatment with Litfulo, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Litfulo interacts with supplements, herbs, or vitamins, see the “Litfulo 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 Litfulo. Keep in mind that this table doesn’t include all drugs that may interact with Litfulo. Some of these interactions are described in detail just below in “Drug interactions in depth.”

In some cases, factors or conditions could prevent your doctor from prescribing Litfulo due to the risk of harm. These are known as contraindications. Allergic reaction is the only contraindication of Litfulo.

Having had an allergic reaction to Litfulo or any of its ingredients

If you have had an allergic reaction to Litfulo or any of its ingredients, your doctor will likely not prescribe Litfulo. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Litfulo, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Litfulo.

There aren’t any known interactions between Litfulo and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Litfulo treatment.

This is because drinking alcohol while taking the drug may worsen some of Litfulo’s side effects. For example, you may experience headache, dizziness, or diarrhea.

In addition, consuming large amounts of alcohol can cause liver damage. Litfulo may also cause liver damage as a side effect. This means that drinking alcohol during Litfulo treatment may increase the risk of liver problems.

If you consume alcohol during Litfulo treatment, these side effects may be more likely to occur. If you have questions about drinking alcohol while taking Litfulo, talk with your doctor.

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

Certain CYP3A4 substrates

CYP3A4 substrates are drugs that are broken down by an enzyme in your body called cytochrome P450 3A4 (CYP3A4). This enzyme is responsible for clearing several different drugs from your body. These drugs have many different uses.

Interaction result: Taking Litfulo with certain CYP3A4 substrates can increase the risk of side effects from the CYP3A4 substrate.

Interaction explained: Litfulo reduces the activity of CYP3A4, so it can reduce the breakdown of CYP3A4 substrates. As a result, these drugs can build up in your body. For most CYP3A4 substrates, small changes in the level of the drug in your body won’t have a significant effect. But for some CYP3A4 substrates, the risk of serious side effects increases if the level of the drug in your body increases by just a small amount.

Examples of drugs that are CYP3A4 substrates: Here are some CYP3A4 substrates that may interact with Litfulo:

• colchicine (Colcrys)
• cyclosporine (Neoral, others)
• dihydroergotamine (Migranal, Trudhesa)
• midazolam (Seizalam)
• pimozide
• quinidine
• sirolimus (Rapamune, others)
• tacrolimus (Prograf, Astagraf XL)

Steps you or your doctor may take: Before you start Litfulo, tell your doctor about all the medications you take. They can check whether the drugs you take are CYP3A4 substrates that may interact with Litfulo.

If you take Litfulo with certain CYP3A4 substrates, your doctor may reduce your dosage of the CYP3A4 substrate. Do not take a higher dosage of either medication than your doctor prescribes.

Certain CYP1A2 substrates

CYP1A2 substrates are drugs that are broken down by an enzyme in your body called cytochrome P450 1A2 (CYP1A2). This enzyme is responsible for clearing certain drugs from your body.

Interaction result: Taking Litfulo with some CYP1A2 substrates can increase the risk of side effects from the CYP1A2 substrate.

Interaction explained: Litfulo reduces the activity of CYP1A2, so it can reduce the breakdown of CYP1A2 substrates. As a result, these drugs can build up in your body. For most CYP1A2 substrates, small changes in the level of the drug in your body won’t have a significant effect. But for some CYP1A2 substrates, the risk of serious side effects increases if the level of the drug in your body increases by just a small amount.

Examples of drugs that are CYP1A2 substrates: Here are some CYP1A2 substrates that may interact with Litfulo:

• pirfenidone (Esbriet)
• theophylline (Theo-24, others)
• tizanidine (Zanaflex)

Steps you or your doctor may take: Before you start Litfulo, tell your doctor about all the medications you take. They can check whether these drugs are CYP1A2 substrates that can interact with Litfulo.

If you take Litfulo with certain CYP1A2 substrates, your doctor may reduce your dosage of the CYP1A2 substrate. Do not take a higher dosage of either medication than your doctor prescribes.

Rifampin

Litfulo can interact with rifampin (Rifadin, Rimactane), which is an antibiotic prescribed to treat certain bacterial infections, including TB.

Interaction result: Taking Litfulo with rifampin could make Litfulo less effective.

Interaction explained: Rifampin increases the activity of an enzyme in your body that breaks down Litfulo. So taking Litfulo with rifampin can cause Litfulo to be cleared from your body faster than is typical. This can lower the level of Litfulo in your body, making it less effective at treating your condition.

Steps you or your doctor may take: Your doctor likely won’t prescribe Litfulo with rifampin. You can talk with your doctor about other treatment options.

Litfulo 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 Litfulo.

Litfulo interactions with supplements

Before you start treatment with Litfulo, 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.

Litfulo interactions with herbs

Doctors will typically recommend you avoid taking St. John’s wort with Litfulo. St. John’s wort is an herbal supplement that some people take to help treat depression and other conditions.

St. John’s wort may speed up the activity of an enzyme in your body called CYP3A4. This enzyme helps break down Litfulo.

By speeding up this enzyme, St. John’s wort can cause Litfulo to break down more quickly. And this may lead to a low level of Litfulo in your system. If the level of Litfulo in your system is too low, the drug may not work to treat alopecia.

Your doctor may be able to suggest a treatment option other than St. John’s wort.

Litfulo and vitamins

There are no specific reports of vitamins interacting with Litfulo. 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 Litfulo.

Litfulo interactions with food

Litfulo may interact with caffeine.

Litfulo reduces the action of an enzyme in your body that breaks down caffeine, called CYP1A2. Consuming too much caffeine while taking Litfulo can increase the risk of side effects from caffeine. These can include fast heart rate, heart palpitations, anxiety, tremor, insomnia, and seizure.

Examples of foods and beverages that contain caffeine include:

• coffee
• tea
• chocolate
• energy drinks

Because of this interaction, your doctor will likely recommend limiting how much caffeine you consume during Litfulo treatment.

If you’d like to learn more about eating certain foods during treatment with Litfulo, talk with your doctor.

Litfulo interactions with vaccines

Litfulo may interact with live vaccines. A live vaccine contains live but weakened pieces of the virus or bacterium it’s meant to defend against. When your immune system is functioning effectively, live vaccines won’t typically cause infection.

But Litfulo can weaken your immune system. So if you get a live vaccine, your immune system may not be able to fight the virus or bacterium. This may cause you to become sick or develop symptoms of the illness the vaccine is meant to prevent.

Examples of live vaccines to avoid during Litfulo treatment include:

• measles, mumps, rubella (MMR)
• chickenpox
• flu vaccine (nasal spray form)
• yellow fever
• typhoid (oral)

Before starting Litfulo, talk with your doctor or pharmacist about any vaccines you may need.

Litfulo interactions with lab tests

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

LITFULO DRUG INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Litfulo. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Litfulo. The effects of cannabis may affect how well you stick to your Litfulo treatment plan.

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

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

Health conditions or factors that might interact with Litfulo include:

• Cardiovascular risk factors: Litfulo has boxed warnings* about the risks of cardiovascular problems and blood clots. You may have a raised risk of these side effects if you’re age 50 years or older or have other cardiovascular risk factors. These can include smoking, high blood pressure, high cholesterol, diabetes, and obesity. Your doctor will take into account your age and health history to determine whether Litfulo is safe for you.
• Infections: Litfulo has a boxed warning* about the risk of serious infections. Before starting Litfulo, tell your doctor about any serious infections you’ve had in the past, such as TB or hepatitis. Also, tell your doctor if you have any active infections or infections that keep coming back. And talk with your doctor about your immunization history.
• Cancer: Litfulo has a boxed warning* about the risk of certain cancers. If you’ve ever smoked or had cancer, talk with your doctor about whether Litfulo is right for you.
• Allergic reaction: If you’ve had an allergic reaction to Litfulo or any of its ingredients, your doctor will likely not prescribe Litfulo. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Liver problems: If you have a liver problem, Litfulo may make it worse. Litfulo hasn’t been trialed in people with severe liver problems. If you have a liver problem, talk with your doctor about whether Litfulo is right for you.
• Low white blood cell or platelet counts: If you have a low white blood cell or platelet count, Litfulo may make it worse. Talk with your doctor about whether Litfulo is right for you.
• Breastfeeding: You should not breastfeed while taking Litfulo and for at least 14 hours after your last dose. There isn’t enough information to determine whether the drug passes into breast milk or what effects Litfulo may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before taking Litfulo. 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 Litfulo is safe to take while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects) or pregnancy loss. However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Litfulo. They can advise you on the right treatment plan for you.

* A boxed warning is the most 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 section at the top of this article.

You can take certain steps to help prevent interactions with Litfulo. 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 Litfulo 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 Litfulo 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 Litfulo by taking it exactly as your doctor prescribes.

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

• Overview of Litfulo: For a general overview of Litfulo, you can see this article.
• Facts about alopecia: To learn more about your condition, see this article on alopecia areata.

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.