Mayzent interactions: Alcohol, medications, and other factors

Mayzent interactions with other medications  

Before you start treatment with Mayzent, 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 Mayzent interacts with supplements, herbs, or vitamins, see the “Mayzent and other interactions” section.)

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 Mayzent. Keep in mind that this table doesn’t include all drugs that may interact with Mayzent. Some of these interactions are described in detail in “Drug interactions in depth.”

When to avoid Mayzent

In some cases, factors or conditions could prevent your doctor from prescribing Mayzent due to the risk of harm. These are known as contraindications. Doctors typically won’t prescribe Mayzent if any contraindication applies to you, due to the risk of harm. Instead, talk with your doctor about other multiple sclerosis treatments that are safer for you.

The contraindications of Mayzent include:

Having a CYP2C9*3/*3 genotype

CYP2C9 is an enzyme (a type of protein) your liver makes that helps break down certain medications, including Mayzent. A CYP2C9*3/*3 genotype is a rare genetic difference that results in very low CYP2C9 activity in your system.

As a result, it’s difficult for your body to break down medications like Mayzent after you take a dose. This causes levels of the drug to build up, which can increase your risk of side effects.

Before prescribing Mayzent, your doctor will likely order a test to check your CYP2C9 genotype. Depending on the result, they may choose to not prescribe Mayzent. Or, they may prescribe a lower dosage. Your doctor can provide more information on CYP2C9 genotype testing and how the results may affect your treatment.

Having certain cardiovascular complications in the last 6 months

Mayzent can cause cardiovascular (heart and blood vessel) side effects. Due to this risk, certain people were not included in studies of Mayzent. As a result, it’s not known whether the drug is safe to take if you have experienced certain cardiovascular complications within the 6 months prior to starting treatment with Mayzent.

These cardiovascular complications include any of the following:

• heart attack
• heart failure exacerbation requiring hospitalization
• class 3 or 4 heart failure
• a stroke or transient ischemic attack, sometimes called a “ministroke”
• unstable angina

Having certain heart rhythm problems without a pacemaker

If you have certain heart rhythm problems, your doctor likely won’t prescribe Mayzent unless you have a pacemaker. This is due to Mayzent’s risk of cardiovascular side effects, including new or worsened heart rhythm problems.

These heart rhythm problems include:

• Mobitz type 2 second- or third-degree heart block
• sick sinus syndrome

Before prescribing Mayzent, your doctor may order an electrocardiogram (ECG or EKG) to check for issues with your heart rhythm. If you have a heart rhythm problem listed above and do not have a pacemaker, your doctor can discuss other multiple sclerosis treatments besides Mayzent with you.

Mayzent interaction with alcohol

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

Consuming large amounts of alcohol can cause liver damage. Mayzent may also cause liver damage as a side effect. This means that drinking alcohol during Mayzent treatment may increase the risk of liver problems.

Alcohol can also worsen the condition you’re receiving Mayzent to treat. If you have multiple sclerosis, drinking alcohol may worsen your symptoms.

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

Drug interactions in depth

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

Certain medications that can cause QT prolongation

Mayzent can interact with certain medications that can cause QT prolongation. The QT interval refers to a specific part of your heart’s natural rhythm.

Interaction result: Taking Mayzent with a medication that increases the QT interval can increase the risk of an arrhythmia (including QT prolongation) as a side effect of Mazyent and medications that increase the QT interval.

With QT prolongation, your heart muscle takes longer to contract and relax than normal. This disrupts your heart rhythm. QT prolongation may not cause symptoms in some cases. In others, it may cause heart palpitations, sudden fainting, and dizziness. In rare cases, it can lead to life threatening complications including torsades de pointes and cardiac arrest.

Interaction explained: Mayzent is known to affect the heart’s rhythm. A slow heart rate and arrhythmias are known side effects of the medication. However, these side effects are usually mild and short-term for most people.

In rare cases, these side effects can persist or become serious. The risk of long-term or serious complications is increased by certain other factors. This includes taking other medications that can affect your heart rhythm, including medications that increase the QT interval.

Examples of medications that increase the QT interval: Here are some medications that prolong the QT interval and may interact with Mayzent:

• citalopram (Celexa)
• levofloxacin
• methadone (Methadose)
• quetiapine (Seroquel)
• sotalol (Betapace, Sotylize)

It’s important to note that some drugs can also interact with Mayvent in more than one way. The combination of some drugs with Mayvent can increase Mayvent levels and cause QT prolongation. An example of this interaction is the drug ketoconazole.

Steps you or your doctor may take: Due to the risk of QT prolongation, doctors often won’t prescribe Mayzent if you’re taking a medication that prolongs the QT interval. They may seek advice from your cardiologist if they want to prescribe Mayzent to you. Your cardiologist and doctor can provide more detail on how they’ll determine if Mayzent is safe for you if you also take a medication that prolongs the QT interval.

Medications that affect CYP2C9 and CYP3A4

Mayzent can interact with medications that affect the enzymes (proteins) CYP2C9 and CYP3A4.

Interaction result: Taking Mayzent with a medication or medications that slow down or block CYP2C9 and CYP3A4 can increase the level of Mayzent in your body. This raises your risk of side effects that Mayzent can cause.

Taking Mayzent with a medication or medications that speed up CYP2C9 and CYP3A4 can decrease the level of Mayzent in your body. This can make Mayzent less effective.

Taking Mayzent with a medication that blocks only CYP2C9 can increase the level of Mayzent in your system. Taking Mayzent with a medication that speeds up only CYP2C9 can decrease the level of Mayzent in your system. On the other hand, medications that only block or speed up CYP3A4 are not expected to interact with Mayzent, unless you also take a medication that speeds up or blocks CYP2C9.

Interaction explained: The enzymes CYP2C9 and CYP3A4 help break down certain medications, including Mayzent, after you take a dose.

Medications that slow down activity of these enzymes are called CYP2C9 or CYP3A4 inhibitors (blockers). Medications that speed up their activity are called CYP2C9 or CYP3A4 inducers.

Examples of medications that affect CYP2C9 or CYP3A4: Here are some medications that may interact with Mayzent:

Examples of CYP2C9 inhibitors include:

• amiodarone (Pacerone)
• fluconazole (Diflucan)

Examples of CYP3A4 inhibitors include:

• clarithromycin
• ketoconazole
• ritonavir (Norvir) and treatments that contain it
• cobicistat (Tybost) and treatments that contain it

Examples of CYP2C9 inducers include:

• enzalutamide (Xtandi)
• rifampin (Rimactane)

Examples of CYP3A4 inducers include:

• carbamazepine (Tegretol, others)
• phenytoin (Dilantin)
• apalutamide (Erleada)
• rifampin (Rimactane)

Steps you or your doctor may take: Your doctor will review your medication list and determine whether Mayzent is safe for you to take. They may suggest changing other medications you take in order for you to safely take Mayzent. Or, they may suggest you try other multiple sclerosis treatments besides Mayzent.

Immunosuppressants

Mayzent can interact with immunosuppressants, which are medications that lower activity in your immune system.

Interaction result: Taking Mayzent with an immunosupressant can increase the risk of infection as a side effect of Mayzent and immunosuppressants.

Interaction explained: Both Mayzent and immunosupressants lower activity in your immune system. This increases your risk of infection. If these medications are taken together, the risk of infection further increases.

Examples of immunosuppressant drugs: Here are some immunosuppressant drugs that may interact with Mayzent:

• alemtuzumab (Lemtrada, Campath)
• dexamethasone and other corticosteroids
• cyclosporine
• tacrolimus
• glatiramer (Copaxone, Glatopa)

Steps you or your doctor may take: Due to the risk of infection, your doctor may avoid prescribing Mayzent if you’re taking an immunosupressant. For example, Mayzent usually isn’t prescribed if you’ve received treatment with alemtuzumab. For other immunosupressants, your doctor will weigh the risk and benefit of prescribing Mayzent with your other medication(s).

Mayzent and other interactions

Mayzent 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 Mayzent.

Mayzent interactions with supplements

Before you start treatment with Mayzent, 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.

Mayzent interactions with herbs

Doctors will typically recommend you avoid taking St. John’s wort with Mayzent. St. John’s wort is an herbal supplement that may be used to treat depression and other conditions.

St. John’s wort may speed up the activity of enzymes in your body called CYP3A4 and CYP2C9. These enzymes helps break down Mayzent.

By speeding up these enzymes, St. John’s wort can cause Mayzent to break down more quickly, which may lead to a low level of Mayzent in your system. If the level of Mayzent in your system is too low, the drug may not work to treat multiple sclerosis.

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

Mayzent can also interact with black pepper supplements. This is because black pepper contains piperine, which can slow down the CYP2C9 enzyme. Your doctor may suggest you avoid using a black pepper supplement if you’re prescribed Mayzent.

Mayzent interactions with vitamins

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

Mayzent interactions with food

Grapefruit and grapefruit juice can interact with Mayzent. Specifically, grapefruit products can stop your body from breaking down Mayzent. This raises the level of Mayzent in your body, which increases your risk of side effects from Mayzent.* Due to this risk, your doctor will likely recommend not consuming grapefruit and grapefruit juice while taking the drug.

Note: Although black pepper supplements may interact with Mayzent, black pepper in food isn’t expected to interact with Mayzent.

* For details about Mayzent’s side effects, see this article.

Mayzent interactions with vaccines

Mayzent is known to 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 healthy, live vaccines usually won’t cause infection.

However, Mayzent works by affecting activity in 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 Mayzent treatment include:

• measles, mumps, rubella (MMR)
• chickenpox
• flu vaccine (nasal spray form)

In addition, Mayzent may make inactivated vaccines (vaccines which contain a killed version of the virus or bacterium it’s meant to defend against) less effective. This effect can continue for up to 1 month after your last dose of Mayzent.

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

Mayzent interactions with lab tests

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

MAYZENT INTERACTION WITH CANNABIS OR CBD

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

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

Mayzent and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with Mayzent. Before you take this drug, be sure to talk with your doctor about your health history. Mayzent 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 Mayzent include:

• Heart rhythm or cardiovascular problems: Mayzent can cause side effects that affect the heart rhythm or cardiovascular (heart and blood vessel) system. To learn more, see the “When to avoid Mayzent” section.
• Having a CYP2C9*3/*3 genotype: CYP2C9 is an enzyme (a type of protein) made by your liver which helps break down certain medications, including Mayzent. To learn more, see the “When to avoid Mayzent” section.
• Breathing problems, such as asthma: Mayzent can cause issues related to breathing as a side effect, such as a lower forced expiratory volume in the first second (FEV1). This refers to how much air you can force out of your lungs in 1 second. If you have a condition that affects breathing, such as asthma, taking Mayzent may worsen your condition.
• Current infection: If you have an active infection, your doctor will likely want to treat it before prescribing Mayzent to you. Mayzent lowers activity in your immune system, which can make it harder to treat an infection.
• Diabetes or uveitis (a type of inflammation in the eye): People with these conditions have an increased risk of developing macular edema as a side effect from taking Mayzent. If your doctor prescribes Mayzent, they may want to closely monitor your eye health throughout treatment.
• High blood pressure: Taking Mayzent can increase your blood pressure. If you already have high blood pressure, your doctor may decide to prescribe a multiple sclerosis (MS) treatment other than Mayzent. If they do prescribe Mayzent, they’ll want to monitor your blood pressure during treatment. They may adjust the dose of blood pressure medications you take.
• Liver problems: Mayzent can cause liver injury as a side effect. If you have an existing liver condition, such as fatty liver disease, your doctor may monitor your liver health closely if they prescribe Mayzent to you.
• Past or current skin cancer: Taking Mayzent can increase your risk of skin cancer. If you have or have had skin cancer, your doctor may decide to prescribe an MS treatment other than Mayzent.
• Allergic reaction: If you’ve had an allergic reaction to Mayzent or any of its ingredients, your doctor will likely not prescribe Mayzent. 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 use Mayzent while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Mayzent may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Mayzent. 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 Mayzent is safe to use 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 Mayzent. They can advise you on the right treatment plan for you.

Preventing interactions

You can take certain steps to help prevent interactions with Mayzent. 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 you are taking.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Mayzent 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 Mayzent 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 Mayzent by taking it exactly as your doctor prescribes.

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.