"004.005" . . . "4.5\tInterakce s\u00A0jin\u00FDmi l\u00E9\u010Div\u00FDmi p\u0159\u00EDpravky a jin\u00E9 formy interakce"@cs . . "Interak\u010Dn\u00ED studie byly provedeny s\u00A0kofeinem, ergotaminem, dihydroergotaminem, paracetamolem, metoklopramidem, pizotifenem, fluoxetinem, rifampicinem a propranololem a nebyl zji\u0161t\u011Bn \u017E\u00E1dn\u00FD klinicky v\u00FDznamn\u00FD rozd\u00EDl ve farmakokinetice zolmitriptanu nebo jeho aktivn\u00EDho metabolitu.\n\u00DAdaje z\u00EDskan\u00E9 u\u00A0zdrav\u00FDch dobrovoln\u00EDk\u016F ukazuj\u00ED, \u017Ee neexistuje klinicky v\u00FDznamn\u00E1 interakce mezi zolitriptanem a ergotaminem. Ov\u0161em existuje teoreticky zv\u00FD\u0161en\u00E9 riziko koron\u00E1rn\u00EDch vasospazm\u016F, a proto je soub\u011B\u017En\u00E9 pod\u00E1v\u00E1n\u00ED kontraindikov\u00E1no. Doporu\u010Duje se \u010Dekat alespo\u0148 24\u00A0hodin po pod\u00E1n\u00ED p\u0159\u00EDpravk\u016F s\u00A0ergotaminem p\u0159ed pod\u00E1n\u00EDm zolmitriptanu. Doporu\u010Duje se \u010Dekat alespo\u0148 6\u00A0hodin po pod\u00E1n\u00ED zolmitriptanu p\u0159ed pod\u00E1n\u00EDm p\u0159\u00EDpravk\u016F s\u00A0ergotaminem (viz bod 4.3).\nPo pod\u00E1n\u00ED moklobemidu, specifick\u00E9ho inhibitoru MAO\u2011A, do\u0161lo k\u00A0m\u00EDrn\u00E9mu (26%) n\u00E1r\u016Fstu AUC pro zolmitriptan a k\u00A0trojn\u00E1sobn\u00E9mu zv\u011Bt\u0161en\u00ED AUC pro aktivn\u00ED metabolit. Proto se pro pacienty u\u017E\u00EDvaj\u00EDc\u00ED inhibitory MAO\u2011A doporu\u010Duje maxim\u00E1ln\u00ED d\u00E1vka p\u0159\u00EDpravku Zomig 5\u00A0mg za 24\u00A0hodin. L\u00E9\u010Div\u00E9 p\u0159\u00EDpravky nelze u\u017E\u00EDvat soub\u011B\u017En\u011B, pokud se pod\u00E1v\u00E1 d\u00E1vka moklobemidu vy\u0161\u0161\u00ED ne\u017E 150\u00A0mg dvakr\u00E1t denn\u011B.\nPo pod\u00E1n\u00ED cimetidinu, inhibitor cytochromu P450, se polo\u010Das zolmitriptanu zv\u00FD\u0161il o\u00A044\u00A0% a AUC o\u00A048\u00A0%. Krom\u011B toho se zdvojn\u00E1sobily hodnoty polo\u010Dasu a AUC pro aktivn\u00ED N\u2011demethylovan\u00FD metabolit zolmitriptanu (183C91). Pro pacienty, kte\u0159\u00ED u\u017E\u00EDvaj\u00ED cimetidin, se proto doporu\u010Duje maxim\u00E1ln\u00ED d\u00E1vka 5\u00A0mg p\u0159\u00EDpravku Zomig za 24\u00A0hodin. S\u00A0p\u0159ihl\u00E9dnut\u00EDm k\u00A0celkov\u00E9mu interak\u010Dn\u00EDmu profilu nelze vylou\u010Dit interakci s\u00A0inhibitory isoenzymu CYP1A2 cytochromu P450. Z\u00A0tohoto d\u016Fvodu se stejn\u00E9 sn\u00ED\u017Een\u00ED d\u00E1vky p\u0159\u00EDpravku Zomig doporu\u010Duje p\u0159i sou\u010Dasn\u00E9m pod\u00E1v\u00E1n\u00ED s\u00A0t\u011Bmito l\u00E1tkami, nap\u0159. fluvoxamin a chinolony (nap\u0159. ciprofloxacin).\nPod\u00E1v\u00E1n\u00ED selegilinu (inhibitor MAO\u2011B) a fluoxetinu nevedlo k\u00A0farmakokinetick\u00E9 interakci se zolmitriptanem. Byly v\u0161ak hl\u00E1\u0161eny p\u0159\u00EDpady popisuj\u00EDc\u00ED p\u0159\u00EDznaky kompatibiln\u00ED s\u00A0serotoninov\u00FDm syndromem (v\u010Detn\u011B alterace ment\u00E1ln\u00EDho stavu, autonomn\u00ED nestability a neuromuskul\u00E1rn\u00EDch abnormit) po pod\u00E1n\u00ED SSRIs nebo SNRIs a zolmitriptanu (viz bod 4.4).\nZolmitriptan m\u016F\u017Ee, podon\u011B jako jin\u00ED 5HT1B/1D agonist\u00E9, zpomalovat absorpci jin\u00FDch l\u00E9\u010Div\u00FDch l\u00E1tek.\nJe t\u0159eba vylou\u010Dit pod\u00E1n\u00ED jin\u00FDch 5HT1B/1D agonist\u016F v\u00A0dob\u011B do 24\u00A0hodin po pod\u00E1n\u00ED zolmitriptanu. Pod\u00E1n\u00ED zolmitriptanu v\u00A0dob\u011B do 24\u00A0hodin po pod\u00E1n\u00ED jin\u00FDch 5HT1B/1D agonist\u016F je t\u0159eba vylou\u010Dit.\n"@cs . . . . . . .