News & Perspective
Drugs & Diseases
CME & Education
Academy
Video
Decision Point
Edition: English

Medscape

English
Deutsch
Español
Français
Português
UKNew

Univadis

Sign Up It's Free!
English Edition

Medscape

Univadis

    X
    Univadis from Medscape

    No Results

      News & Perspective Drugs & Diseases CME & Education Academy Video Decision Point
      Drugs & Diseases

      difelikefalin (Rx)

      Brand and Other Names:Korsuva
      • Print

      Dosing & Uses

      AdultPediatric

      Dosage Forms & Strengths

      injectable solution

      • 65mcg/1.3mL

      Pruritus

      Indicated for moderate-to-severe pruritus associated with chronic kidney disease in adults undergoing hemodialysis (HD)

      0.5 mcg/kg IV push into venous line of dialysis circuit at the end of each HD treatment

      Dosage Modifications

      Hepatic impairment

      • Mild-to-moderate: No dosage adjustment needed
      • Severe: Pharmacokinetics not evaluated; use not recommended

      Dosing Considerations

      Limitation of use

      • Not studied in patients on peritoneal dialysis; use not recommended

      Safety and efficacy not established

      Next:

      Interactions

      Interaction Checker

      and difelikefalin

      No Results

         activity indicator 
        No Interactions Found
        Interactions Found

        Contraindicated

          Serious - Use Alternative

            Significant - Monitor Closely

              Minor

                All Interactions Sort By:
                 activity indicator 

                Contraindicated (0)

                  Serious - Use Alternative (2)

                  • olopatadine intranasal

                    difelikefalin and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

                  • ropeginterferon alfa 2b

                    ropeginterferon alfa 2b and difelikefalin both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.

                  Monitor Closely (219)

                  • acetazolamide

                    difelikefalin and acetazolamide both increase sedation. Use Caution/Monitor.

                  • alfentanil

                    difelikefalin and alfentanil both increase sedation. Use Caution/Monitor.

                  • alprazolam

                    difelikefalin and alprazolam both increase sedation. Use Caution/Monitor.

                  • amantadine

                    difelikefalin and amantadine both increase sedation. Use Caution/Monitor.

                  • amitriptyline

                    difelikefalin and amitriptyline both increase sedation. Use Caution/Monitor.

                  • amobarbital

                    difelikefalin and amobarbital both increase sedation. Use Caution/Monitor.

                  • amoxapine

                    difelikefalin and amoxapine both increase sedation. Use Caution/Monitor.

                  • apomorphine

                    difelikefalin and apomorphine both increase sedation. Use Caution/Monitor.

                  • arbaclofen

                    difelikefalin and arbaclofen both increase sedation. Use Caution/Monitor.

                  • aripiprazole

                    difelikefalin and aripiprazole both increase sedation. Use Caution/Monitor.

                  • asenapine

                    difelikefalin and asenapine both increase sedation. Use Caution/Monitor.

                  • asenapine transdermal

                    difelikefalin and asenapine transdermal both increase sedation. Use Caution/Monitor.

                  • baclofen

                    difelikefalin and baclofen both increase sedation. Use Caution/Monitor.

                  • belladonna and opium

                    difelikefalin and belladonna and opium both increase sedation. Use Caution/Monitor.

                  • benzhydrocodone/acetaminophen

                    difelikefalin and benzhydrocodone/acetaminophen both increase sedation. Use Caution/Monitor.

                  • brexanolone

                    difelikefalin and brexanolone both increase sedation. Use Caution/Monitor.

                  • brexpiprazole

                    difelikefalin and brexpiprazole both increase sedation. Use Caution/Monitor.

                  • bromocriptine

                    difelikefalin and bromocriptine both increase sedation. Use Caution/Monitor.

                  • brompheniramine

                    difelikefalin and brompheniramine both increase sedation. Use Caution/Monitor.

                  • buprenorphine

                    difelikefalin and buprenorphine both increase sedation. Use Caution/Monitor.

                  • buprenorphine transdermal

                    difelikefalin and buprenorphine transdermal both increase sedation. Use Caution/Monitor.

                  • bupropion

                    difelikefalin and bupropion both increase sedation. Use Caution/Monitor.

                  • buspirone

                    difelikefalin and buspirone both increase sedation. Use Caution/Monitor.

                  • butabarbital

                    difelikefalin and butabarbital both increase sedation. Use Caution/Monitor.

                  • butalbital

                    difelikefalin and butalbital both increase sedation. Use Caution/Monitor.

                  • butorphanol

                    difelikefalin and butorphanol both increase sedation. Use Caution/Monitor.

                  • carbamazepine

                    difelikefalin and carbamazepine both increase sedation. Use Caution/Monitor.

                  • carbinoxamine

                    difelikefalin and carbinoxamine both increase sedation. Use Caution/Monitor.

                  • cariprazine

                    difelikefalin and cariprazine both increase sedation. Use Caution/Monitor.

                  • carisoprodol

                    difelikefalin and carisoprodol both increase sedation. Use Caution/Monitor.

                  • cenobamate

                    difelikefalin and cenobamate both increase sedation. Use Caution/Monitor.

                  • chloral hydrate

                    difelikefalin and chloral hydrate both increase sedation. Use Caution/Monitor.

                  • chlordiazepoxide

                    difelikefalin and chlordiazepoxide both increase sedation. Use Caution/Monitor.

                  • chlorpheniramine

                    difelikefalin and chlorpheniramine both increase sedation. Use Caution/Monitor.

                  • chlorpromazine

                    difelikefalin and chlorpromazine both increase sedation. Use Caution/Monitor.

                  • chlorzoxazone

                    difelikefalin and chlorzoxazone both increase sedation. Use Caution/Monitor.

                  • citalopram

                    difelikefalin and citalopram both increase sedation. Use Caution/Monitor.

                  • clemastine

                    difelikefalin and clemastine both increase sedation. Use Caution/Monitor.

                  • clobazam

                    difelikefalin and clobazam both increase sedation. Use Caution/Monitor.

                  • clomipramine

                    difelikefalin and clomipramine both increase sedation. Use Caution/Monitor.

                  • clonazepam

                    difelikefalin and clonazepam both increase sedation. Use Caution/Monitor.

                  • clonidine

                    difelikefalin and clonidine both increase sedation. Use Caution/Monitor.

                  • clorazepate

                    difelikefalin and clorazepate both increase sedation. Use Caution/Monitor.

                  • clozapine

                    difelikefalin and clozapine both increase sedation. Use Caution/Monitor.

                  • codeine

                    difelikefalin and codeine both increase sedation. Use Caution/Monitor.

                  • cyclobenzaprine

                    difelikefalin and cyclobenzaprine both increase sedation. Use Caution/Monitor.

                  • cyproheptadine

                    difelikefalin and cyproheptadine both increase sedation. Use Caution/Monitor.

                  • dantrolene

                    difelikefalin and dantrolene both increase sedation. Use Caution/Monitor.

                  • daridorexant

                    difelikefalin and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

                  • desflurane

                    difelikefalin and desflurane both increase sedation. Use Caution/Monitor.

                  • desipramine

                    difelikefalin and desipramine both increase sedation. Use Caution/Monitor.

                  • desvenlafaxine

                    difelikefalin and desvenlafaxine both increase sedation. Use Caution/Monitor.

                  • deutetrabenazine

                    difelikefalin and deutetrabenazine both increase sedation. Use Caution/Monitor.

                  • dexchlorpheniramine

                    difelikefalin and dexchlorpheniramine both increase sedation. Use Caution/Monitor.

                  • dexmedetomidine

                    difelikefalin and dexmedetomidine both increase sedation. Use Caution/Monitor.

                  • diazepam

                    difelikefalin and diazepam both increase sedation. Use Caution/Monitor.

                  • diazepam buccal

                    difelikefalin and diazepam buccal both increase sedation. Use Caution/Monitor.

                  • diazepam intranasal

                    difelikefalin and diazepam intranasal both increase sedation. Use Caution/Monitor.

                  • dichloralphenazone

                    difelikefalin and dichloralphenazone both increase sedation. Use Caution/Monitor.

                  • dichlorphenamide

                    difelikefalin and dichlorphenamide both increase sedation. Use Caution/Monitor.

                  • difenoxin hcl

                    difelikefalin and difenoxin hcl both increase sedation. Use Caution/Monitor.

                  • dimenhydrinate

                    difelikefalin and dimenhydrinate both increase sedation. Use Caution/Monitor.

                  • diphenhydramine

                    difelikefalin and diphenhydramine both increase sedation. Use Caution/Monitor.

                  • diphenoxylate hcl

                    difelikefalin and diphenoxylate hcl both increase sedation. Use Caution/Monitor.

                  • divalproex sodium

                    difelikefalin and divalproex sodium both increase sedation. Use Caution/Monitor.

                  • doxepin

                    difelikefalin and doxepin both increase sedation. Use Caution/Monitor.

                  • doxylamine

                    difelikefalin and doxylamine both increase sedation. Use Caution/Monitor.

                  • dronabinol

                    difelikefalin and dronabinol both increase sedation. Use Caution/Monitor.

                  • droperidol

                    difelikefalin and droperidol both increase sedation. Use Caution/Monitor.

                  • duloxetine

                    difelikefalin and duloxetine both increase sedation. Use Caution/Monitor.

                  • efavirenz

                    difelikefalin and efavirenz both increase sedation. Use Caution/Monitor.

                  • entacapone

                    difelikefalin and entacapone both increase sedation. Use Caution/Monitor.

                  • escitalopram

                    difelikefalin and escitalopram both increase sedation. Use Caution/Monitor.

                  • esketamine intranasal

                    difelikefalin and esketamine intranasal both increase sedation. Use Caution/Monitor.

                  • eslicarbazepine acetate

                    difelikefalin and eslicarbazepine acetate both increase sedation. Use Caution/Monitor.

                  • estazolam

                    difelikefalin and estazolam both increase sedation. Use Caution/Monitor.

                  • eszopiclone

                    difelikefalin and eszopiclone both increase sedation. Use Caution/Monitor.

                  • ethosuximide

                    difelikefalin and ethosuximide both increase sedation. Use Caution/Monitor.

                  • ethotoin

                    difelikefalin and ethotoin both increase sedation. Use Caution/Monitor.

                  • etomidate

                    difelikefalin and etomidate both increase sedation. Use Caution/Monitor.

                  • felbamate

                    difelikefalin and felbamate both increase sedation. Use Caution/Monitor.

                  • fenfluramine

                    difelikefalin and fenfluramine both increase sedation. Use Caution/Monitor.

                  • fentanyl

                    difelikefalin and fentanyl both increase sedation. Use Caution/Monitor.

                  • fentanyl intranasal

                    difelikefalin and fentanyl intranasal both increase sedation. Use Caution/Monitor.

                  • fentanyl iontophoretic transdermal system

                    difelikefalin and fentanyl iontophoretic transdermal system both increase sedation. Use Caution/Monitor.

                  • fentanyl transdermal

                    difelikefalin and fentanyl transdermal both increase sedation. Use Caution/Monitor.

                  • fentanyl transmucosal

                    difelikefalin and fentanyl transmucosal both increase sedation. Use Caution/Monitor.

                  • flibanserin

                    difelikefalin and flibanserin both increase sedation. Use Caution/Monitor.

                  • fluoxetine

                    difelikefalin and fluoxetine both increase sedation. Use Caution/Monitor.

                  • fluphenazine

                    difelikefalin and fluphenazine both increase sedation. Use Caution/Monitor.

                  • flurazepam

                    difelikefalin and flurazepam both increase sedation. Use Caution/Monitor.

                  • fluvoxamine

                    difelikefalin and fluvoxamine both increase sedation. Use Caution/Monitor.

                  • fosphenytoin

                    difelikefalin and fosphenytoin both increase sedation. Use Caution/Monitor.

                  • gabapentin

                    difelikefalin and gabapentin both increase sedation. Use Caution/Monitor.

                  • gabapentin enacarbil

                    difelikefalin and gabapentin enacarbil both increase sedation. Use Caution/Monitor.

                  • gepirone

                    difelikefalin and gepirone both increase sedation. Use Caution/Monitor.

                  • guanabenz

                    difelikefalin and guanabenz both increase sedation. Use Caution/Monitor.

                  • guanfacine

                    difelikefalin and guanfacine both increase sedation. Use Caution/Monitor.

                  • haloperidol

                    difelikefalin and haloperidol both increase sedation. Use Caution/Monitor.

                  • hydrocodone

                    difelikefalin and hydrocodone both increase sedation. Use Caution/Monitor.

                  • hydromorphone

                    difelikefalin and hydromorphone both increase sedation. Use Caution/Monitor.

                  • hydroxyzine

                    difelikefalin and hydroxyzine both increase sedation. Use Caution/Monitor.

                  • iloperidone

                    difelikefalin and iloperidone both increase sedation. Use Caution/Monitor.

                  • imipramine

                    difelikefalin and imipramine both increase sedation. Use Caution/Monitor.

                  • isoflurane

                    difelikefalin and isoflurane both increase sedation. Use Caution/Monitor.

                  • ketamine

                    difelikefalin and ketamine both increase sedation. Use Caution/Monitor.

                  • lacosamide

                    difelikefalin and lacosamide both increase sedation. Use Caution/Monitor.

                  • lamotrigine

                    difelikefalin and lamotrigine both increase sedation. Use Caution/Monitor.

                  • levodopa

                    difelikefalin and levodopa both increase sedation. Use Caution/Monitor.

                  • levorphanol

                    difelikefalin and levorphanol both increase sedation. Use Caution/Monitor.

                  • lithium

                    difelikefalin and lithium both increase sedation. Use Caution/Monitor.

                  • lorazepam

                    difelikefalin and lorazepam both increase sedation. Use Caution/Monitor.

                  • loxapine

                    difelikefalin and loxapine both increase sedation. Use Caution/Monitor.

                  • loxapine inhaled

                    difelikefalin and loxapine inhaled both increase sedation. Use Caution/Monitor.

                  • loxicodegol

                    difelikefalin and loxicodegol both increase sedation. Use Caution/Monitor.

                  • lumateperone

                    difelikefalin and lumateperone both increase sedation. Use Caution/Monitor.

                  • lurasidone

                    difelikefalin and lurasidone both increase sedation. Use Caution/Monitor.

                  • maprotiline

                    difelikefalin and maprotiline both increase sedation. Use Caution/Monitor.

                  • meclizine

                    difelikefalin and meclizine both increase sedation. Use Caution/Monitor.

                  • meperidine

                    difelikefalin and meperidine both increase sedation. Use Caution/Monitor.

                  • mephobarbital

                    difelikefalin and mephobarbital both increase sedation. Use Caution/Monitor.

                  • meprobamate

                    difelikefalin and meprobamate both increase sedation. Use Caution/Monitor.

                  • metaxalone

                    difelikefalin and metaxalone both increase sedation. Use Caution/Monitor.

                  • methadone

                    difelikefalin and methadone both increase sedation. Use Caution/Monitor.

                  • methocarbamol

                    difelikefalin and methocarbamol both increase sedation. Use Caution/Monitor.

                  • methohexital

                    difelikefalin and methohexital both increase sedation. Use Caution/Monitor.

                  • methsuximide

                    difelikefalin and methsuximide both increase sedation. Use Caution/Monitor.

                  • methyldopa

                    difelikefalin and methyldopa both increase sedation. Use Caution/Monitor.

                  • metyrosine

                    difelikefalin and metyrosine both increase sedation. Use Caution/Monitor.

                  • midazolam

                    difelikefalin and midazolam both increase sedation. Use Caution/Monitor.

                  • midazolam intranasal

                    difelikefalin and midazolam intranasal both increase sedation. Use Caution/Monitor.

                  • mirtazapine

                    difelikefalin and mirtazapine both increase sedation. Use Caution/Monitor.

                  • molindone

                    difelikefalin and molindone both increase sedation. Use Caution/Monitor.

                  • morphine

                    difelikefalin and morphine both increase sedation. Use Caution/Monitor.

                  • nabilone

                    difelikefalin and nabilone both increase sedation. Use Caution/Monitor.

                  • nalbuphine

                    difelikefalin and nalbuphine both increase sedation. Use Caution/Monitor.

                  • nefazodone

                    difelikefalin and nefazodone both increase sedation. Use Caution/Monitor.

                  • nitrous oxide

                    difelikefalin and nitrous oxide both increase sedation. Use Caution/Monitor.

                  • nortriptyline

                    difelikefalin and nortriptyline both increase sedation. Use Caution/Monitor.

                  • olanzapine

                    difelikefalin and olanzapine both increase sedation. Use Caution/Monitor.

                  • oliceridine

                    difelikefalin and oliceridine both increase sedation. Use Caution/Monitor.

                  • opium tincture

                    difelikefalin and opium tincture both increase sedation. Use Caution/Monitor.

                  • orphenadrine

                    difelikefalin and orphenadrine both increase sedation. Use Caution/Monitor.

                  • oxazepam

                    difelikefalin and oxazepam both increase sedation. Use Caution/Monitor.

                  • oxcarbazepine

                    difelikefalin and oxcarbazepine both increase sedation. Use Caution/Monitor.

                  • oxybutynin

                    difelikefalin and oxybutynin both increase sedation. Use Caution/Monitor.

                  • oxycodone

                    difelikefalin and oxycodone both increase sedation. Use Caution/Monitor.

                  • oxymorphone

                    difelikefalin and oxymorphone both increase sedation. Use Caution/Monitor.

                  • paliperidone

                    difelikefalin and paliperidone both increase sedation. Use Caution/Monitor.

                  • paregoric

                    difelikefalin and paregoric both increase sedation. Use Caution/Monitor.

                  • paroxetine

                    difelikefalin and paroxetine both increase sedation. Use Caution/Monitor.

                  • pentazocine

                    difelikefalin and pentazocine both increase sedation. Use Caution/Monitor.

                  • pentobarbital

                    difelikefalin and pentobarbital both increase sedation. Use Caution/Monitor.

                  • perampanel

                    difelikefalin and perampanel both increase sedation. Use Caution/Monitor.

                  • perphenazine

                    difelikefalin and perphenazine both increase sedation. Use Caution/Monitor.

                  • pheniramine

                    difelikefalin and pheniramine both increase sedation. Use Caution/Monitor.

                  • phenobarbital

                    difelikefalin and phenobarbital both increase sedation. Use Caution/Monitor.

                  • phenytoin

                    difelikefalin and phenytoin both increase sedation. Use Caution/Monitor.

                  • pimavanserin

                    difelikefalin and pimavanserin both increase sedation. Use Caution/Monitor.

                  • pimozide

                    difelikefalin and pimozide both increase sedation. Use Caution/Monitor.

                  • pramipexole

                    difelikefalin and pramipexole both increase sedation. Use Caution/Monitor.

                  • pregabalin

                    difelikefalin and pregabalin both increase sedation. Use Caution/Monitor.

                  • primidone

                    difelikefalin and primidone both increase sedation. Use Caution/Monitor.

                  • prochlorperazine

                    difelikefalin and prochlorperazine both increase sedation. Use Caution/Monitor.

                  • promethazine

                    difelikefalin and promethazine both increase sedation. Use Caution/Monitor.

                  • propofol

                    difelikefalin and propofol both increase sedation. Use Caution/Monitor.

                  • protriptyline

                    difelikefalin and protriptyline both increase sedation. Use Caution/Monitor.

                  • quazepam

                    difelikefalin and quazepam both increase sedation. Use Caution/Monitor.

                  • quetiapine

                    difelikefalin and quetiapine both increase sedation. Use Caution/Monitor.

                  • ramelteon

                    difelikefalin and ramelteon both increase sedation. Use Caution/Monitor.

                  • rasagiline

                    difelikefalin and rasagiline both increase sedation. Use Caution/Monitor.

                  • remifentanil

                    difelikefalin and remifentanil both increase sedation. Use Caution/Monitor.

                  • remimazolam

                    difelikefalin and remimazolam both increase sedation. Use Caution/Monitor.

                  • risperidone

                    difelikefalin and risperidone both increase sedation. Use Caution/Monitor.

                  • ropinirole

                    difelikefalin and ropinirole both increase sedation. Use Caution/Monitor.

                  • rotigotine

                    difelikefalin and rotigotine both increase sedation. Use Caution/Monitor.

                  • rufinamide

                    difelikefalin and rufinamide both increase sedation. Use Caution/Monitor.

                  • safinamide

                    difelikefalin and safinamide both increase sedation. Use Caution/Monitor.

                  • samidorphan

                    difelikefalin and samidorphan both increase sedation. Use Caution/Monitor.

                  • scopolamine

                    difelikefalin and scopolamine both increase sedation. Use Caution/Monitor.

                  • secobarbital

                    difelikefalin and secobarbital both increase sedation. Use Caution/Monitor.

                  • selegiline

                    difelikefalin and selegiline both increase sedation. Use Caution/Monitor.

                  • selegiline transdermal

                    difelikefalin and selegiline transdermal both increase sedation. Use Caution/Monitor.

                  • sertraline

                    difelikefalin and sertraline both increase sedation. Use Caution/Monitor.

                  • sevoflurane

                    difelikefalin and sevoflurane both increase sedation. Use Caution/Monitor.

                  • sodium oxybate

                    difelikefalin and sodium oxybate both increase sedation. Use Caution/Monitor.

                  • stiripentol

                    difelikefalin and stiripentol both increase sedation. Use Caution/Monitor.

                  • sufentanil

                    difelikefalin and sufentanil both increase sedation. Use Caution/Monitor.

                  • sufentanil SL

                    difelikefalin and sufentanil SL both increase sedation. Use Caution/Monitor.

                  • suvorexant

                    difelikefalin and suvorexant both increase sedation. Use Caution/Monitor.

                  • tapentadol

                    difelikefalin and tapentadol both increase sedation. Use Caution/Monitor.

                  • tasimelteon

                    difelikefalin and tasimelteon both increase sedation. Use Caution/Monitor.

                  • temazepam

                    difelikefalin and temazepam both increase sedation. Use Caution/Monitor.

                  • tetrabenazine

                    difelikefalin and tetrabenazine both increase sedation. Use Caution/Monitor.

                  • thalidomide

                    difelikefalin and thalidomide both increase sedation. Use Caution/Monitor.

                  • theophylline

                    difelikefalin and theophylline both increase sedation. Use Caution/Monitor.

                  • thioridazine

                    difelikefalin and thioridazine both increase sedation. Use Caution/Monitor.

                  • thiothixene

                    difelikefalin and thiothixene both increase sedation. Use Caution/Monitor.

                  • tiagabine

                    difelikefalin and tiagabine both increase sedation. Use Caution/Monitor.

                  • tizanidine

                    difelikefalin and tizanidine both increase sedation. Use Caution/Monitor.

                  • tolcapone

                    difelikefalin and tolcapone both increase sedation. Use Caution/Monitor.

                  • topiramate

                    difelikefalin and topiramate both increase sedation. Use Caution/Monitor.

                  • tramadol

                    difelikefalin and tramadol both increase sedation. Use Caution/Monitor.

                  • trazodone

                    difelikefalin and trazodone both increase sedation. Use Caution/Monitor.

                  • triazolam

                    difelikefalin and triazolam both increase sedation. Use Caution/Monitor.

                  • trifluoperazine

                    difelikefalin and trifluoperazine both increase sedation. Use Caution/Monitor.

                  • trimethobenzamide

                    difelikefalin and trimethobenzamide both increase sedation. Use Caution/Monitor.

                  • trimipramine

                    difelikefalin and trimipramine both increase sedation. Use Caution/Monitor.

                  • triprolidine

                    difelikefalin and triprolidine both increase sedation. Use Caution/Monitor.

                  • valerian

                    difelikefalin and valerian both increase sedation. Use Caution/Monitor.

                  • valproic acid

                    difelikefalin and valproic acid both increase sedation. Use Caution/Monitor.

                  • vigabatrin

                    difelikefalin and vigabatrin both increase sedation. Use Caution/Monitor.

                  • vilazodone

                    difelikefalin and vilazodone both increase sedation. Use Caution/Monitor.

                  • vortioxetine

                    difelikefalin and vortioxetine both increase sedation. Use Caution/Monitor.

                  • zaleplon

                    difelikefalin and zaleplon both increase sedation. Use Caution/Monitor.

                  • zileuton

                    difelikefalin and zileuton both increase sedation. Use Caution/Monitor.

                  • ziprasidone

                    difelikefalin and ziprasidone both increase sedation. Use Caution/Monitor.

                  • zolpidem

                    difelikefalin and zolpidem both increase sedation. Use Caution/Monitor.

                  • zonisamide

                    difelikefalin and zonisamide both increase sedation. Use Caution/Monitor.

                  Minor (0)

                    Previous
                    Next:

                    Adverse Effects

                    1-10%

                    Diarrhea (9%)

                    Dizziness (6.8%)

                    Nausea (6.6%)

                    Gait disturbances (6.6%)

                    Hyperkalemia (4.7%)

                    Headache (4.5%)

                    Somnolence (4.2%)

                    Mental status change (3.3%)

                    Previous
                    Next:

                    Warnings

                    Contraindications

                    None

                    Cautions

                    Dizziness, somnolence, mental status changes, and gait disturbances (eg, falls) have occurred; may subside over time with continued treatment

                    May impair mental or physical abilities; advise patients not to drive or operate dangerous machinery until effect on a patient’s ability to drive or operate machinery is known

                    Drug interaction overview

                    • Centrally acting depressant medications, sedating antihistamines, and opioid analgesics may increase the adverse reactions of difelikefalin; use with caution
                    Previous
                    Next:

                    Pregnancy & Lactation

                    Pregnancy

                    Limited human data are insufficient on use in pregnant females to evaluate drug-associated risks for major birth defects or miscarriage

                    Lactation

                    There are no data regarding drug presence in human milk, effects on breastfed infants, or effects on milk production

                    Studies showed difelikefalin was transferred into milk in lactating rats

                    When a drug is present in animal milk, it is likely that the drug will be present in human milk

                    Pregnancy Categories

                    A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                    B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                    C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                    D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                    X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                    NA: Information not available.

                    Previous
                    Next:

                    Pharmacology

                    Mechanism of Action

                    Kappa opioid receptor (KOR) agonist

                    Relevance of KOR activation to therapeutic effectiveness is unknown

                    Absorption

                    Steady-state was reached after second dose

                    Mean accumulation ratio: 1.6

                    Distribution

                    Vd: 238 mL/kg

                    Protein bound: 23-28%

                    Elimination

                    Half-life (before dialysis): 23-31 hr

                    Excretion: Urine (11%); feces (59%); dialysate fluid (20%)

                    Previous
                    Next:

                    Administration

                    IV Preparation

                    Do not mix or dilute before administration

                    Visually inspect vials for particulate matter and discoloration before administering; solution should be clear and colorless; discard vials if particulate matter or discoloration is observed

                    Vials are for single-dose use; discard any unused product

                    May use the following formula to determine total injection volume on target body weight or may refer to prescribing information

                    Total injection volume (mL) = Patient target dry body weight (kg) x 0.01, rounded to the nearest tenth (0.1 mL)

                    IV Administration

                    Administer after blood is no longer circulating through the dialyzer; dialyzer membrane removes difelikefalin

                    Administer IV push into venous line of the dialysis circuit at the end of each HD session

                    May be given either during or after rinse back of dialysis circuit

                    Dose given after rinse back: Administer into venous line followed by ≥10 mL of 0.9% NaCl flush

                    Dose given during rinse back: No additional 0.9% NaCl is needed to flush line

                    Administer within 60 minutes of syringe preparation; discard any unused product

                    Missed regularly scheduled HD treatment: Resume at the end of next HD treatment

                    Storage

                    Unopened vials

                    • Store at 20-25ºC (68-77ºF); excursions permitted to 15-30ºC (59-86ºF)
                    • Do not freeze

                    Prepared syringe

                    • Store at 20-25ºC (68-77ºF); discard after 60 minutes of syringe preparation
                    Previous
                    Next:

                    Images

                    No images available for this drug.
                    Previous
                    Next:

                    Patient Handout

                    A Patient Handout is not currently available for this monograph.
                    Previous
                    Next:

                    Formulary

                    FormularyPatient Discounts

                    Adding plans allows you to compare formulary status to other drugs in the same class.

                    To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

                    Create Your List of Plans

                    Adding plans allows you to:

                    • View the formulary and any restrictions for each plan.
                    • Manage and view all your plans together – even plans in different states.
                    • Compare formulary status to other drugs in the same class.
                    • Access your plan list on any device – mobile or desktop.

                    The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                    View explanations for tiers and restrictions
                    Tier Description
                    1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                    2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                    3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                    4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                    5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                    6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                    NC NOT COVERED – Drugs that are not covered by the plan.
                    Code Definition
                    PA Prior Authorization
                    Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                    QL Quantity Limits
                    Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                    ST Step Therapy
                    Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                    OR Other Restrictions
                    Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
                    CLOSE
                    Additional Offers
                    CLOSE
                    Email to Patient

                    From:

                    To:

                    The recipient will receive more details and instructions to access this offer.

                    By clicking send, you acknowledge that you have permission to email the recipient with this information.

                    CLOSE
                    Email Forms to Patient

                    From:

                    To:

                    The recipient will receive more details and instructions to access this offer.

                    By clicking send, you acknowledge that you have permission to email the recipient with this information.

                    Previous
                    Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.
                    Find Us On
                    About
                    About Medscape Privacy Policy Editorial Policy Cookies Terms of Use Advertising Policy Help Center
                    Membership
                    Become a Member About You Professional Information Newsletters & Alerts Market Research
                    App
                    Medscape
                    WebMD Network
                    Medscape Live Events WebMD MedicineNet eMedicineHealth RxList WebMD Corporate Medscape UK
                    Editions
                    English Deutsch Español Français Português UK
                    All material on this website is protected by copyright, Copyright © 1994-2023 by WebMD LLC. This website also contains material copyrighted by 3rd parties.