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Drug Interactions between allogeneic processed thymus tissue and Tazverik

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

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Interactions between your drugs

Major

tazemetostat allogeneic processed thymus tissue

Applies to: Tazverik (tazemetostat) and allogeneic processed thymus tissue

MONITOR CLOSELY: Prolonged use of immunosuppressants, particularly high-dose corticosteroids, after administration of allogenic thymocyte-depleted thymus tissue implant, may increase the risk of damage to the implant. However, Graft Versus Host Disease (GVHD) may be caused by or exacerbated by allogenic thymocyte-depleted thymus tissue implant in patients with congenital athymia and require treatment with systemic immunosuppressive therapy. In addition, patients with congenital athymia are at an increased risk of autologous GVHD (aGVHD), which may also require systemic immunosuppressive therapy, including treatment with corticosteroids such as methylprednisolone and prednisolone.

MANAGEMENT: The manufacturer advises that prolonged use of immunosuppressive therapies, including high-dose corticosteroids, should be avoided in patients who have received an allogenic thymocyte-depleted thymus tissue implant. Some authorities consider the use of high-dose corticosteroids in the period immediately after implant to be contraindicated and generally advise against the use of pulse corticosteroids (such as methylprednisolone 30 to 40 mg/kg/day for 3 days) post-implant due to the potential for permanent damage to the implant. If immunosuppressive therapy is required post-implant, patients should be closely monitored for signs of damage to the implant as well as adverse effects from the concomitant immunosuppressant(s). The concomitant immunosuppressant(s) should be weaned as soon as clinically possible.

References

  1. (2021) "Product Information. Rethymic (allogeneic processed thymus tissue)." Enzyvant Therapeutics Inc., 1
  2. Gupton, S.E, McCarthy, E.A, Markert, M.L (2021) "Care of children with DiGeorge before and after cultured thymus tissue implantation" J Clin Immunol, 41, p. 896-905

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Drug and food interactions

Major

tazemetostat food

Applies to: Tazverik (tazemetostat)

GENERALLY AVOID: Consumption of grapefruit or grapefruit juice during tazemetostat therapy may significantly increase the plasma concentrations of tazemetostat. The proposed mechanism is inhibition of the CYP450 3A4-mediated metabolism of tazemetostat by certain compounds in grapefruit. Because grapefruit juice inhibits primarily intestinal rather than hepatic CYP450 3A4, the magnitude of interaction is greatest for those drugs that undergo significant presystemic metabolism by CYP450 3A4 (i.e., drugs with low oral bioavailability). According to the product labeling, coadministration of tazemetostat (400 mg twice daily) with the moderate CYP450 3A4 inhibitor fluconazole increased the tazemetostat steady state exposure (AUC 0 to 8 hours) by 3.1-fold and peak plasma concentration by 2.3-fold. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition. Pharmacokinetic interactions involving grapefruit juice are also subject to a high degree of interpatient variability, thus the extent to which a given patient may be affected is difficult to predict. Clinically, this interaction may result in an increased risk of the frequency or severity of adverse reactions due to tazemetostat such as hemorrhage, pleural effusion, skin infection, dyspnea, pain, and respiratory distress.

MANAGEMENT: The manufacturer advises that patients treated with tazemetostat should avoid consumption of grapefruit or grapefruit juice.

References

  1. (2020) "Product Information. Tazverik (tazemetostat)." Epizyme, Inc

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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.


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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.