Drug interactions between Adapin and crizotinib
| Results for the following 2 drugs: |
|---|
| Adapin (doxepin) |
| crizotinib |
Interactions between your selected drugs
doxepin ↔ crizotinib
Applies to:Adapin (doxepin) and crizotinib
MONITOR CLOSELY: Crizotinib can cause concentration-dependent prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result in additive effects and increased risk of ventricular arrhythmias including torsade de pointes and sudden death. In clinical trials of patients who received crizotinib 250 mg twice daily, 4 of 308 patients (1.3%) developed QTcF (Fridericia-corrected QT interval) greater than or equal to 500 msec, and 10 of 289 patients (3.5%) had an increase in QTcF from baseline greater than or equal to 60 msec. A pharmacokinetic/pharmacodynamic analysis suggested a concentration-dependent increase in QTcF. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia, hypocalcemia). Moreover, the extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drug(s).
MANAGEMENT: Caution is advised if crizotinib is prescribed in combination with other medications that can prolong the QT interval. ECG and serum electrolytes, including potassium, magnesium and calcium, should be monitored before starting crizotinib therapy and periodically during treatment. Crizotinib should not be started if baseline QTc is greater than 500 msec. Likewise, treatment should be interrupted in patients who develop Grade 3 QTc prolongation until recovery to less than or equal to Grade 1, then resumed at 200 mg twice daily. In case of recurrence
of Grade 3 QTc prolongation, therapy should be withheld until recovery to less than or equal to Grade 1, then resumed at 250 mg once daily. Permanently discontinue crizotinib therapy if Grade 3 QTc prolongation recurs or at any time during treatment if Grade 4 QTc prolongation develops. Patients should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, palpitations, irregular heartbeat, shortness of breath, or syncope.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| 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. |
Do not stop taking any medications without consulting your healthcare provider.
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