Drug interactions
Azelastine + Lemborexant
Severity: Moderate
Azelastine and Lemborexant: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Lemborexant is metabolized by CYP3A4, and weak CYP3A4 inhibitors can increase its exposure and next-day somnolence. Azelastine is a weak inhibitor and nasal use gives low systemic exposure, so the effect is probably small. Azelastine itself can also cause drowsiness.
What this interaction means in plain words
Azelastine and Lemborexant can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Azelastine belongs to Respiratory; Lemborexant belongs to Central Nervous System.
Why it happens
Weak CYP3A4 inhibition by azelastine may raise lemborexant levels, plus additive sedation.
What to do
Monitor for next-day drowsiness and impaired psychomotor performance. Use the lower lemborexant dose recommended with weak CYP3A4 inhibitors if sedation occurs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Azelastine
Other interactions of Lemborexant
Frequently asked questions
Can I take Azelastine with Lemborexant?
MediHelp rates the interaction as moderate. Azelastine and Lemborexant can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Lemborexant is metabolized by CYP3A4, and weak CYP3A4 inhibitors can increase its exposure and next-day somnolence. Azelastine is a weak inhibitor and nasal use gives low systemic exposure, so the effect is probably small. Azelastine itself can also cause drowsiness.
How serious is the interaction between Azelastine and Lemborexant?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for next-day drowsiness and impaired psychomotor performance. Use the lower lemborexant dose recommended with weak CYP3A4 inhibitors if sedation occurs.
What other medicines interact with Azelastine?
MediHelp also lists interactions of Azelastine with, for example, Calcium / magnesium / potassium / sodium oxybates, Methadone, Sodium oxybate. The full list is on the Azelastine page.
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