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Drug Interactions between aminolevulinic acid and avapritinib

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

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Interactions between your drugs

Major

aminolevulinic acid avapritinib

Applies to: aminolevulinic acid and avapritinib

GENERALLY AVOID: Patients exposed to photosensitizing agents around the same time as oral aminolevulinic acid may be at an increased risk of a phototoxic skin reaction (severe sunburn). These agents have each been individually associated with photosensitivity reactions and may have additive effects when used together. Medicinal products with known phototoxic or photoallergic potential include, but are not limited to, hypericin-containing products (e.g., St. John's Wort), griseofulvin, thiazide diuretics, sulfonylureas, phenothiazines, sulfonamides, quinolones, tetracyclines, and topical aminolevulinate preparations. There is one case report of a severe sunburn lasting for 5 days in a patient who used oral aminolevulinic acid concurrently with a hypericin extract.

MANAGEMENT: Photosensitizing agents (e.g., fluoroquinolones, phenothiazines, retinoids, sulfonamides, sulfonylureas, tetracyclines, thiazide diuretics, griseofulvin, St. John's wort) and topical preparations containing aminolevulinic acid should be avoided for 24 hours before and after oral administration of aminolevulinic acid. Some authorities recommend avoiding exposure to any photosensitizing agent for up to 2 weeks after oral administration of aminolevulinic acid. Patients should also avoid exposure of the eyes and skin to sunlight and bright indoor lights (e.g., examination lamps, operating room lamps, tanning beds, lights at close proximity) for 48 hours after treatment.

References

  1. Hoffman GA, Gradl G, Schulz M, Haidinger G, Tanew A, Weber B (2020) "The frequency of photosensitizing drug dispensings in Austria and Germany: A correlation with their photosensitizing potential based on published literature." J Eur Acad Dermatol Venereol, 34, p. 589-600
  2. Blakely KM, Drucker AM, Rosen CF (2019) "Drug-induced photosensitivity—an update: Culprit drugs, prevention and management." Drug Saf, 42, p. 827-47
  3. (2023) "Product Information. Gliolan (aminolevulinic acid)." Medac UK
  4. (2022) "Product Information. Gleolan (aminolevulinic acid)." Medexus pharma Inc
  5. (2020) "Product Information. Gleolan (aminolevulinic acid)." Medexus Inc
  6. (2021) "Product Information. Gliolan (aminolevulinic acid)." Specialised Therapeutics Australia Pty Ltd
View all 6 references

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Drug and food interactions

Major

avapritinib food

Applies to: avapritinib

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of avapritinib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Inhibition of hepatic CYP450 3A4 may also contribute. The interaction has not been studied with grapefruit juice, but has been reported for other CYP450 3A4 inhibitors. Based on pharmacokinetic modeling, administration of avapritinib (300 mg once daily) in combination with the potent CYP450 3A4 inhibitor itraconazole (200 mg once daily) is predicted to increase avapritinib systemic exposure (AUC) by 600% at steady state, while administration with the moderate CYP450 3A4 inhibitor fluconazole (200 mg once daily) is predicted to increase avapritinib systemic exposure (AUC) by 210% at steady state. 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. Increased exposure to avapritinib may increase the risk and/or severity of serious adverse effects such as intracranial hemorrhage, cognitive impairment, mood disorders, hallucinations, edema, and decreases in hemoglobin, leukocytes, neutrophils, and platelets.

ADJUST DOSING INTERVAL: Food may increase the oral absorption of avapritinib. When avapritinib was administered with a high-calorie, high-fat meal (approximately 909 calories; 58 g carbohydrate, 56 g fat, 43 g protein), avapritinib Cmax and AUC increased by 59% and 29%, respectively, compared to administration in the fasted state.

MANAGEMENT: Avapritinib should be administered on an empty stomach at least 1 hour before or 2 hours after a meal. Patients should avoid consumption of grapefruit and grapefruit juice during treatment with avapritinib.

References

  1. (2020) "Product Information. Ayvakit (avapritinib)." Blueprint Medicines Corporation

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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

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