DDInter998 DDInter1480
Ivermectin is a semi-synthetic antiparasitic medication derived from avermectins, a class of highly-active broad-spectrum antiparasitic agents isolated from the fermentation products of _Streptomyces avermitilis_. Ivermectin itself is a mixture of two avermectins, comprising roughly 90% 5-O-demethyl-22,23-dihydroavermectin A<sub>1a</sub> (22,23-dihydroavermectin B<sub>1a</sub>) and 10% 5-O-demethyl-25-de(1-methylpropyl)-22,23-dihydro­-25-(1-methylethyl)avermectin A<sub>1a</sub> (22,23-dihydroavermectin B<sub>1b</sub>). Ivermectin is mainly used in humans in the
Pitolisant is a selective antagonist or inverse agonist of the histamine H3 receptor used to treat type 1 or 2 narcolepsy. Narcolepsy is a chronic neurological disorder that affects 1 in 2,000 individuals and is characterized by excessive daytime sleepiness, abnormal REM sleep manifestations, sleep paralysis and hypnagogic hallucinations. About 60-70% of patients with narcolepsy experience cataplexy, which is a sudden loss of muscle tone triggered by positive or negative emotions. Histaminergic neuron signalling in the brain plays a role in maintaining wakefulness; by blocking histamine autoreceptors, pitolisant enhances the activity of histaminergic neurons, as well as increasing the signalling of other neurotransmitters in the brain. In a European clinical trial of adult patients with narcolepsy, there was a reduction in the Epworth Sleepiness Scale (ESS) score from pitolisant therapy compared to placebo. The therapeutic effectiveness of pitolisant was comparable to that of [modafinil]. Pitolisant therapy was also effective in treating refractory sleepiness in adolescent patients with narcolepsy, where it decreased ESS score and increased the mean sleep onset latency. Adolescent patients with cataplexy also experienced a slight improvement in the frequency and severity of symptoms ; however, the safety of use in adolescent or paediatric patients have not been established with pitolisant. Commonly marketed under the trade name Wakix, oral pitolisant was approved by the EMA in 2016 for the treatment of narcolepsy with or without cataplexy. FDA approved the use of pitolisant in 2019 for excessive daytime sleepiness (EDS) associated with narcolepsy in adults.
Ivermectin {u} (Compound) binds {v} (Gene) CYP3A4
CYP3A4 {u} (Gene) is bound by {v} (Compound) Metronidazole
Metronidazole {u} may cause a minor interaction that can limit clinical effects when taken with {v} Pitolisant
Ivermectin {u} (Compound) causes {v} (Side Effect) Skin burning sensation
Skin burning sensation {u} (Side Effect) is caused by {v} (Compound) Metronidazole
Metronidazole {u} may cause a minor interaction that can limit clinical effects when taken with {v} Pitolisant
Ivermectin {u} (Compound) binds {v} (Gene) CYP3A4
CYP3A4 {u} (Gene) is bound by {v} (Compound) Fluconazole
Fluconazole {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Pitolisant
Ivermectin {u} (Compound) causes {v} (Side Effect) Skin burning sensation
Skin burning sensation {u} (Side Effect) is caused by {v} (Compound) Isotretinoin
Isotretinoin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Pitolisant
Ivermectin {u} (Compound) causes {v} (Side Effect) Skin burning sensation
Skin burning sensation {u} (Side Effect) is caused by {v} (Compound) Crizotinib
Crizotinib {u} may lead to a major life threatening interaction when taken with {v} Pitolisant
Ivermectin {u} (Compound) upregulates {v} (Gene) ATF3
ATF3 {u} (Gene) is upregulated by {v} (Compound) Bisacodyl
Bisacodyl {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Pitolisant
Ivermectin {u} (Compound) binds {v} (Gene) CYP3A4
CYP3A4 {u} (Gene) is bound by {v} (Compound) Halofantrine
Halofantrine {u} may lead to a major life threatening interaction when taken with {v} Pitolisant
Ivermectin {u} (Compound) upregulates {v} (Gene) HMOX1
HMOX1 {u} (Gene) is downregulated by {v} (Compound) Idarubicin
Idarubicin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Pitolisant
Ivermectin {u} (Compound) upregulates {v} (Gene) BTG1
BTG1 {u} (Gene) is upregulated by {v} (Compound) Crizotinib
Crizotinib {u} may lead to a major life threatening interaction when taken with {v} Pitolisant
Ivermectin {u} (Compound) downregulates {v} (Gene) JMJD6
JMJD6 {u} (Gene) is upregulated by {v} (Compound) Bisacodyl
Bisacodyl {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Pitolisant
Ivermectin (Compound) binds CYP3A4 (Gene) and CYP3A4 (Gene) is bound by Metronidazole (Compound) and Metronidazole may cause a minor interaction that can limit clinical effects when taken with Pitolisant
Ivermectin (Compound) causes Skin burning sensation (Side Effect) and Skin burning sensation (Side Effect) is caused by Metronidazole (Compound) and Metronidazole may cause a minor interaction that can limit clinical effects when taken with Pitolisant
Ivermectin (Compound) binds CYP3A4 (Gene) and CYP3A4 (Gene) is bound by Fluconazole (Compound) and Fluconazole may cause a moderate interaction that could exacerbate diseases when taken with Pitolisant
Ivermectin (Compound) causes Skin burning sensation (Side Effect) and Skin burning sensation (Side Effect) is caused by Isotretinoin (Compound) and Isotretinoin may cause a moderate interaction that could exacerbate diseases when taken with Pitolisant
Ivermectin (Compound) causes Skin burning sensation (Side Effect) and Skin burning sensation (Side Effect) is caused by Crizotinib (Compound) and Crizotinib may lead to a major life threatening interaction when taken with Pitolisant
Ivermectin (Compound) upregulates ATF3 (Gene) and ATF3 (Gene) is upregulated by Bisacodyl (Compound) and Bisacodyl may cause a moderate interaction that could exacerbate diseases when taken with Pitolisant
Ivermectin (Compound) binds CYP3A4 (Gene) and CYP3A4 (Gene) is bound by Halofantrine (Compound) and Halofantrine may lead to a major life threatening interaction when taken with Pitolisant
Ivermectin (Compound) upregulates HMOX1 (Gene) and HMOX1 (Gene) is downregulated by Idarubicin (Compound) and Idarubicin may cause a moderate interaction that could exacerbate diseases when taken with Pitolisant
Ivermectin (Compound) upregulates BTG1 (Gene) and BTG1 (Gene) is upregulated by Crizotinib (Compound) and Crizotinib may lead to a major life threatening interaction when taken with Pitolisant
Ivermectin (Compound) downregulates JMJD6 (Gene) and JMJD6 (Gene) is upregulated by Bisacodyl (Compound) and Bisacodyl may cause a moderate interaction that could exacerbate diseases when taken with Pitolisant