Drug interactions
Pyrimethamine + Sapropterin
Severity: Moderate
Pyrimethamine and Sapropterin: 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
Sapropterin is a synthetic form of tetrahydrobiopterin, and its recycling depends on folate-related enzymes. Pyrimethamine inhibits dihydrofolate reductase, which is also involved in pterin metabolism, so sapropterin effect may be reduced. The clinical significance is uncertain.
What this interaction means in plain words
Pyrimethamine and Sapropterin 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.
Pyrimethamine belongs to Anti Parasitic; Sapropterin belongs to Miscellaneous.
Why it happens
Pyrimethamine, a DHFR inhibitor, may impair regeneration of tetrahydrobiopterin and so lessen sapropterin effect.
What to do
Monitor blood phenylalanine more often when the two are combined, and adjust the sapropterin dose if control worsens.
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 Pyrimethamine
- Deferiprone + Pyrimethamine Major
- Eliglustat + Pyrimethamine Major
- Acalabrutinib + Pyrimethamine Moderate
- Brexpiprazole + Pyrimethamine Moderate
- Dapsone + Pyrimethamine Moderate
- Folic acid + Pyrimethamine Moderate
Other interactions of Sapropterin
- Avanafil + Sapropterin Moderate
- Carbidopa-entacapone-levodopa + Sapropterin Moderate
- Carbidopa-levodopa + Sapropterin Moderate
- Levodopa + Sapropterin Moderate
- Methotrexate + Sapropterin Moderate
- Phenobarbitone + Sapropterin Moderate
Frequently asked questions
Can I take Pyrimethamine with Sapropterin?
MediHelp rates the interaction as moderate. Pyrimethamine and Sapropterin 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. Sapropterin is a synthetic form of tetrahydrobiopterin, and its recycling depends on folate-related enzymes. Pyrimethamine inhibits dihydrofolate reductase, which is also involved in pterin metabolism, so sapropterin effect may be reduced. The clinical significance is uncertain.
How serious is the interaction between Pyrimethamine and Sapropterin?
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 blood phenylalanine more often when the two are combined, and adjust the sapropterin dose if control worsens.
What other medicines interact with Pyrimethamine?
MediHelp also lists interactions of Pyrimethamine with, for example, Deferiprone, Eliglustat, Acalabrutinib. The full list is on the Pyrimethamine page.
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