Dosing & Drug Interactions

Dosing WAKIX With Other Medications

Some medications have clinically important drug interactions with WAKIX

Choose from the drop-down menu or from the drug categories below.

This tool is not intended to provide an exhaustive list of drug interactions with WAKIX, and some drugs may have other interactions and/or safety considerations. Before prescribing, always consult the Full Prescribing Information for WAKIX as well as for concomitant medications.

Amiodarone Bupropion Carbamazepine Chlorpromazine Clomipramine Cyclosporine Diphenhydramine Disopyramide
Hormonal contraceptives Imipramine Midazolam Mirtazapine Moxifloxacin Paroxetine Pheniramine maleate Phenytoin
Procainamide Promethazine Quinidine Rifampin Sotalol Thioridazine Ziprasidone
 
Amiodarone Bupropion Carbamazepine Chlorpromazine Clomipramine Cyclosporine Diphenhydramine Disopyramide Hormonal
contraceptives Imipramine Midazolam Mirtazapine
Moxifloxacin Paroxetine Pheniramine
maleate Phenytoin Procainamide Promethazine Quinidine Rifampin Sotalol Thioridazine Ziprasidone
 

Concomitant administration of WAKIX with strong CYP2D6 inhibitors increases WAKIX exposure by 2.2-fold

Dosing modifications for WAKIX are recommended in patients receiving strong CYP2D6 inhibitors

Examples1:
  • Bupropion, Paroxetine

Initiating WAKIX in Patients Currently Receiving Strong CYP2D6 Inhibitors

Titrate WAKIX to a maximum recommended dosage of 17.8 mg once daily

Initiating Strong CYP2D6 Inhibitors in Patients on a Stable Dose of WAKIX

Reduce the WAKIX dose by half upon initiating strong CYP2D6 inhibitors

Back to Top
»

Concomitant use of WAKIX with strong CYP3A4 inducers decreases WAKIX exposure by 50%

Dosing modifications for WAKIX may be required in patients receiving strong CYP3A4 inducers

Examples1:
  • Carbamazepine, Phenytoin, Rifampin

Initiating Strong CYP3A4 Inducers in Patients on a Stable Dose of WAKIX

Assess for loss of efficacy of WAKIX after initiation of a strong CYP3A4 inducer

For patients stable on WAKIX 8.9 mg or 17.8 mg once daily, increase the dose of WAKIX to double the original daily dose over 7 days

Discontinuing Concomitant Strong CYP3A4 Inducers in Patients on a Stable Dose of WAKIX

Reduce the WAKIX dose by half upon discontinuation of concomitant strong CYP3A4 inducers

Back to Top
»
Examples:
  • Certain antihistamines2: Diphenhydramine, Pheniramine maleate, Promethazine
  • Certain tri- or tetracyclic antidepressants: Clomipramine,3 Imipramine,3 Mirtazapine3,4

Concomitant administration of WAKIX with centrally acting histamine 1 (H1) receptor antagonists may reduce the effectiveness of WAKIX

Avoid use of centrally acting H1 receptor antagonists

Back to Top
»
Examples5:
  • Class 1A antiarrhythmics: Disopyramide, Procainamide, Quinidine
  • Class 3 antiarrhythmics: Amiodarone, Sotalol
  • Certain antipsychotics: Chlorpromazine, Thioridazine, Ziprasidone
  • Certain antibiotics: Moxifloxacin

Concomitant administration of WAKIX with drugs known to prolong the QT interval may add to the QT effects of WAKIX and increase the risk of cardiac arrhythmia

Avoid use of drugs known to prolong the QT interval

Back to Top
»
Examples:
  • Cyclosporine,6 Hormonal contraceptives, Midazolam1

Concomitant administration of WAKIX with sensitive CYP3A4 substrates may reduce the effectiveness of sensitive CYP3A4 substrates

The effectiveness of hormonal contraceptives may be reduced during treatment with WAKIX and for 21 days after discontinuing therapy

Patients using hormonal contraception should be advised to use an alternative non-hormonal contraceptive method during treatment with WAKIX and for at least 21 days after discontinuation of WAKIX

Back to Top
»

Concomitant administration of WAKIX with strong CYP2D6 inhibitors increases WAKIX exposure by 2.2-fold

Dosing modifications for WAKIX are recommended in patients receiving strong CYP2D6 inhibitors

Examples1:
Bupropion, Paroxetine

Initiating WAKIX in Patients Currently Receiving Strong CYP2D6 Inhibitors

Titrate WAKIX to a maximum recommended dosage of 17.8 mg once daily

Initiating Strong CYP2D6 Inhibitors in Patients on a Stable Dose of WAKIX

Reduce the WAKIX dose by half upon initiating strong CYP2D6 inhibitors

Concomitant use of WAKIX with strong CYP3A4 inducers decreases WAKIX exposure by 50%

Dosing modifications for WAKIX may be required in patients receiving strong CYP3A4 inducers

Examples1:
Carbamazepine, Phenytoin, Rifampin

Initiating Strong CYP3A4 Inducers in Patients on a Stable Dose of WAKIX

Assess for loss of efficacy of WAKIX after initiation of a strong CYP3A4 inducer

For patients stable on WAKIX 8.9 mg or 17.8 mg once daily, increase the dose of WAKIX to double the original daily dose over 7 days

Discontinuing Concomitant Strong CYP3A4 Inducers in Patients on a Stable Dose of WAKIX

Reduce the WAKIX dose by half upon discontinuation of concomitant strong CYP3A4 inducers

Examples:
Certain antihistamines2: Diphenhydramine, Pheniramine maleate, Promethazine
Certain tri- or tetracyclic antidepressants: Clomipramine,3 Imipramine,3 Mirtazapine3,4

Concomitant administration of WAKIX with centrally acting histamine 1 (H1) receptor antagonists may reduce the effectiveness of WAKIX

Avoid use of centrally acting H1 receptor antagonists

Examples5:
Class 1A antiarrhythmics: Disopyramide, Procainamide, Quinidine
Class 3 antiarrhythmics: Amiodarone, Sotalol
Certain antipsychotics: Chlorpromazine, Thioridazine, Ziprasidone
Certain antibiotics: Moxifloxacin

Concomitant administration of WAKIX with drugs known to prolong the QT interval may add to the QT effects of WAKIX and increase the risk of cardiac arrhythmia

Avoid use of drugs known to prolong the QT interval

Examples:
Cyclosporine,6 Hormonal contraceptives, Midazolam1

Concomitant administration of WAKIX with sensitive CYP3A4 substrates may reduce the effectiveness of sensitive CYP3A4 substrates

The effectiveness of hormonal contraceptives may be reduced during treatment with WAKIX and for 21 days after discontinuing therapy

Patients using hormonal contraception should be advised to use an alternative non-hormonal contraceptive method during treatment with WAKIX and for at least 21 days after discontinuation of WAKIX

Starting patients
on WAKIX »