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Drug Interactions between alpelisib and Eliquis

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

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Interactions between your drugs

Moderate

apixaban alpelisib

Applies to: Eliquis (apixaban) and alpelisib

MONITOR: Coadministration with inducers of CYP450 3A4 and/or P-glycoprotein (P-gp) may decrease the plasma concentrations of apixaban, which is a substrate of both the isoenzyme and the efflux transporter. When apixaban was coadministered with 600 mg/day of rifampin, a dual P-gp and potent CYP450 3A4 inducer, mean apixaban peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 42% and 54%, respectively. No data are available for use with other, less potent CYP450 3A4 or P-gp inducers.

MANAGEMENT: The potential for diminished pharmacologic effects of apixaban should be considered during coadministration with inducers of CYP450 3A4 and/or P-gp. Alternative treatments may be required if an interaction is suspected.

References

  1. (2012) "Product Information. Eliquis (apixaban)." Bristol-Myers Squibb Canada Inc

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Drug and food interactions

Moderate

alpelisib food

Applies to: alpelisib

ADJUST DOSING INTERVAL: Food significantly enhances the oral absorption and bioavailability of alpelisib. When administered with a high-fat high-calorie meal (985 calories with 58.1 g of fat) or a low-fat low-calorie meal (334 calories with 8.7 g of fat) the AUC and Cmax of a single dose of alpelisib was increased by 73% and 84% and 77% and 145%, respectively. There were no clinically significant differences in alpelisib AUC between the two types of meals. In addition, food appears to have a more pronounced effect on the solubility of alpelisib than gastric pH. When coadministered with a single 300 mg dose of alpelisib, ranitidine decreased the absorption and overall exposure of alpelisib. Following administration of ranitidine with a low-fat low-calorie meal, the mean AUC and Cmax of alpelisib was decreased by 21% and 36%, respectively. Administration of ranitidine under fasting conditions reduced the mean AUC and Cmax of alpelisib by 30% and 51%, respectively.

MANAGEMENT: To ensure maximal oral absorption, alpelisib should be administered with a meal.

References

  1. (2019) "Product Information. Piqray (alpelisib)." Novartis Pharmaceuticals

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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.