Drug interactions
Brexpiprazole + Cimetidine
Severity: Moderate
Brexpiprazole and Cimetidine: 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
Cimetidine weakly to moderately inhibits CYP3A4 and CYP2D6, the two main pathways clearing brexpiprazole, which can raise brexpiprazole levels. The risk of adverse effects such as sedation, akathisia and orthostatic hypotension increases, especially when combined inhibition of both pathways occurs.
What this interaction means in plain words
Brexpiprazole and Cimetidine 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.
Brexpiprazole belongs to Central Nervous System; Cimetidine belongs to Gastrointestinal Tract.
Why it happens
Inhibition of CYP2D6 and CYP3A4 reduces brexpiprazole metabolism.
What to do
Monitor for brexpiprazole adverse effects and consider dose reduction, especially in CYP2D6 poor metabolizers or with other inhibitors. Consider an alternative acid suppressant such as famotidine.
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 Cimetidine
- Cimetidine + Dofetilide Contraindicated
- Cimetidine + Fezolinetant Contraindicated
- Alfentanil + Cimetidine Major
- Atazanavir + Cimetidine Major
- Carmustine + Cimetidine Major
- Cimetidine + Citalopram Major
Other interactions of Brexpiprazole
Frequently asked questions
Can I take Brexpiprazole with Cimetidine?
MediHelp rates the interaction as moderate. Brexpiprazole and Cimetidine 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. Cimetidine weakly to moderately inhibits CYP3A4 and CYP2D6, the two main pathways clearing brexpiprazole, which can raise brexpiprazole levels. The risk of adverse effects such as sedation, akathisia and orthostatic hypotension increases, especially when combined inhibition of both pathways occurs.
How serious is the interaction between Brexpiprazole and Cimetidine?
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 brexpiprazole adverse effects and consider dose reduction, especially in CYP2D6 poor metabolizers or with other inhibitors. Consider an alternative acid suppressant such as famotidine.
What other medicines interact with Cimetidine?
MediHelp also lists interactions of Cimetidine with, for example, Dofetilide, Fezolinetant, Alfentanil. The full list is on the Cimetidine page.
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