司替戊醇不能与哪些药物同时服用？

Dravet syndrome (DS) is a severe epileptic encephalopathy. Currently, the traditional anti-epileptic drug sodium valproate combined with clobazam is mainly used to treat it. However, the treatment effect is not good and there is drug resistance. Therefore, finding new treatment options is a hot topic in pediatric epilepsy research. : Also known as stiripentol (DIACOMIT), it is a new type of anti-epileptic drug. It is usually used as an add-on drug for a variety of refractory epilepsy. In recent years, many scholars have used stiripentol as an add-on drug for the treatment of DS. So, which drugs cannot be taken with stiripentol at the same time?

Which drugs should not be taken with stiripentol at the same time?

In vitro data indicate that stiripentol is an inhibitor and inducer of CYP1A2, CYP2B6, and CYP3A4. Due to potential drug interactions, dose adjustments of CYP1A2 substrates (e.g., theophylline, caffeine), CYP2B6 substrates (e.g., sertraline, thiotepa), and CYP3A4 substrates (e.g., midazolam, triazolam, quinidine) should be considered based on clinical circumstances when administered concomitantly with DIACOMIT.

Due to possible inhibition of enzyme/transporter activity, dose reduction of CYP2C8, CYP2C19 substrates (e.g., diazepam, clopidogrel), P-gp substrates (e.g., carbamazepine), and BCRP substrates (e.g., methotrexate, prazosin, glyburide) should be considered if adverse reactions occur when administered concomitantly with DIACOMIT.

Coadministration of DIACOMIT (which inhibits CYP 3A4 and 2C19) with clobazam results in increased plasma concentrations of clobazam (a substrate of CYP 3A4) and norclobazam (the active metabolite of clobazam and a substrate of CYP2C19). This may increase the risk of clobazam-related adverse effects.

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