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No clinical interaction studies have been performed. Difelikefalin does not inhibit or induce CYP450 enzymes, and is not a substrate of CYP450 enzymes. It is not an inhibitor of glucuronidating enzymes either. Difelikefalin is not a substrate or an inhibitor of human transporters (see Pharmacology: Pharmacokinetics under Actions). Therefore, interactions of difelikefalin with other medicinal products are unlikely.
Concurrent administration of medicinal products such as sedating antihistamines, opioid analgesics or other CNS depressants (e.g., clonidine, ondansetron, gabapentin, pregabalin, zolpidem, alprazolam, sertraline, trazodone) may increase the likelihood of dizziness and somnolence (see Precautions).
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