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Drug Interactions between Banzel and Iclusig

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

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Interactions between your drugs

Moderate

rufinamide PONATinib

Applies to: Banzel (rufinamide) and Iclusig (ponatinib)

GENERALLY AVOID: Coadministration with potent inducers of CYP450 3A4 may decrease the plasma concentrations of ponatinib, which is a substrate of the isoenzyme. The interaction has not been evaluated in vitro or in a clinical trial; however, a reduction in ponatinib exposure was observed in simulations using a mechanistic model.

MANAGEMENT: Coadministration of ponatinib in combination with potent CYP450 3A4 inducers such as carbamazepine, dexamethasone, enzalutamide, phenobarbital, phenytoin, rifamycins, and St. John's wort should generally be avoided unless the benefit outweighs the potential risk of ponatinib underexposure. Alternative agents with no or minimal CYP450 3A4 induction potential are recommended whenever possible. If concomitant use is required, close monitoring for signs of reduced therapeutic efficacy is advised. Other known inducers include aminoglutethimide, barbiturates, bexarotene, bosentan, dabrafenib, efavirenz, etravirine, nafcillin, nevirapine, somatrem, somatropin, and various other anticonvulsants, although the extent to which they interact with ponatinib is unknown.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Cerner Multum, Inc. "Australian Product Information." O 0
  3. "Product Information. Iclusig (ponatinib)." Ariad Pharmaceuticals Inc (2012):

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Drug and food interactions

Moderate

rufinamide food

Applies to: Banzel (rufinamide)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of rufinamide. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

ADJUST DOSING INTERVAL: Food enhances the oral absorption and bioavailability of rufinamide. In healthy volunteers, administration of a single 400 mg dose of rufinamide with food resulted in an approximately 56% increase in mean peak plasma concentration (Cmax) and a 34% increase in systemic exposure (AUC) compared to administration during a fasting state.

MANAGEMENT: To ensure maximal oral absorption, it is preferable to administer rufinamide with food. Patients receiving rufinamide should be advised to avoid consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how rufinamide affects them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. "Product Information. Banzel (rufinamide)." Eisai Inc (2008):

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Moderate

PONATinib food

Applies to: Iclusig (ponatinib)

GENERALLY AVOID: Coadministration with grapefruit juice is likely to increase the plasma concentrations of ponatinib, which is primarily metabolized by CYP450 3A4. However, the interaction has not been studied. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit.

MANAGEMENT: The consumption of grapefruit, grapefruit juice, and supplements that contain grapefruit extract should be avoided during treatment with ponatinib.

References

  1. "Product Information. Iclusig (ponatinib)." Ariad Pharmaceuticals Inc (2012):

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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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