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Drug Interactions between Abraxane and resmetirom

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

PACLitaxel protein-bound resmetirom

Applies to: Abraxane (paclitaxel protein-bound) and resmetirom

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with inhibitors of CYP450 2C8 and/or 3A4 may increase the plasma concentrations of paclitaxel, which has been found in vitro to be a substrate of these isoenzymes. Formal clinical drug interaction studies have not been conducted. However, in a case report involving a 77-year-old woman with HER2-positive invasive ductal breast cancer on long-term amiodarone therapy, 4 cycles of paclitaxel (80 mg/m2 weekly) and trastuzumab led to development of increasing abdominal discomfort and skin lesions and a diagnosis of paclitaxel-induced skin toxicity. Switching to reduced dose docetaxel (100 mg or 75 mg/m2 weekly) led to the development of severe skin and mucosal toxicity, requiring hospitalization 8 days after the first docetaxel dose was administered. Analysis of two blood samples taken 9 and 10 days after docetaxel administration showed an approximately fivefold increase in its AUC as well as the presence of paclitaxel in unquantifiable levels, 20 and 21 days after it was last administered. The authors of this case study propose that, in addition to CYP450 3A4 inhibition, CYP450 2C8 and P-glycoprotein inhibition due to amiodarone may also contribute to the interaction.

MANAGEMENT: Clinicians should consider the potential for interaction with drugs that inhibit CYP450 2C8 and/or 3A4 and monitor for evidence of dose-related toxicities of paclitaxel during coadministration, including diarrhea, mucositis, myelosuppression, and peripheral neuropathy.

References

  1. Spencer CM, Faulds D "Paclitaxel. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in the treatment of cancer." Drugs 48 (1994): 794-847
  2. Jamis-Dow CA, Klecker RW, Katki AG, Collins JM "Metabolism of Taxol by human liver microsomes and effect of inhibitors (Meeting abstract)." Proc Annu Meet Am Assoc Cancer Res 34 (1993): a21981993
  3. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb PROD (2001):
  4. Bun SS, Ciccolini J, Bun H, Aubert C, Catalin J "Drug interactions of paclitaxel metabolism in human liver microsomes." J Chemother 15 (2003): 266-74
  5. "Product Information. Abraxane (PACLitaxel protein-bound)." American Pharmaceutical Partners PROD
  6. Cerner Multum, Inc. "Australian Product Information." O 0
  7. Bergmann TK, Filppula AM, Launiainen T, Nielsen F, Backman J, Brosen K "Neurotoxicity and low paclitaxel clearance associated with concomitant clopidogrel therapy in a 60 year old Caucasian woman with ovarian carcinoma." Br J Clin Pharmacol (2015):
  8. Starr SP, Hammann F, Gotta V, et al. "Pharmacokinetic interaction between taxanes and amiodarone leading to severe toxicity." Br J Clin Pharmacol 450 (2016): 22-27
View all 8 references

Drug and food interactions

Moderate

PACLitaxel protein-bound food

Applies to: Abraxane (paclitaxel protein-bound)

Grapefruits and grapefruit juice may increase the blood levels and effects of PACLitaxel protein-bound. This can increase the risk of side effects such as nausea, diarrhea, hair loss, muscle pain or weakness, nerve damage, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. Contact your doctor if you experience paleness, fatigue, dizziness, fainting, unusual bruising or bleeding, fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, pain or burning during urination, vision problems, and/or numbness, burning or tingling in your hands and feet. You may need a dose adjustment and/or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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