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Drug Interactions between Biaxin XL and mirvetuximab soravtansine

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

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Interactions between your drugs

Major

clarithromycin mirvetuximab soravtansine

Applies to: Biaxin XL (clarithromycin) and mirvetuximab soravtansine

MONITOR CLOSELY: Coadministration with potent CYP450 3A4 inhibitors may increase the plasma concentrations and effects of unconjugated DM4, the microtubule inhibitor component of mirvetuximab soravtansine. Mirvetuximab soravtansine is a folate receptor alpha (FR-alpha)-directed antibody-drug conjugate (ADC) that releases DM4 via proteolytic cleavage, and DM4 has been shown to be primarily metabolized by CYP450 3A4. Increased concentrations of unconjugated DM4 may increase the risk of adverse effects including ocular toxicity (e.g., visual impairment, corneal disorders, dry eye, photophobia, eye pain, and uveitis), pneumonitis, and peripheral neuropathy. Clinical data are not available. Other, less potent CYP450 3A4 inhibitors are not expected to interact.

MANAGEMENT: Caution is recommended if mirvetuximab soravtansine is administered in combination with potent CYP450 3A4 inhibitors. Close monitoring for adverse reactions including ocular toxicity, pneumonitis, and peripheral neuropathy is advised. Mirvetuximab soravtansine treatment may need to be discontinued, interrupted, or dosage reduced in patients with serious or life-threatening toxicities in accordance with the product labeling. Alternative treatment that does not interfere with mirvetuximab soravtansine metabolism should be considered whenever possible.

References

  1. (2022) "Product Information. Elahere (mirvetuximab soravtansine)." ImmunoGen, Inc., 1

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Drug and food interactions

Minor

clarithromycin food

Applies to: Biaxin XL (clarithromycin)

Grapefruit juice may delay the gastrointestinal absorption of clarithromycin but does not appear to affect the overall extent of absorption or inhibit the metabolism of clarithromycin. The mechanism of interaction is unknown but may be related to competition for intestinal CYP450 3A4 and/or absorptive sites. In an open-label, randomized, crossover study consisting of 12 healthy subjects, coadministration with grapefruit juice increased the time to reach peak plasma concentration (Tmax) of both clarithromycin and 14-hydroxyclarithromycin (the active metabolite) by 80% and 104%, respectively, compared to water. Other pharmacokinetic parameters were not significantly altered. This interaction is unlikely to be of clinical significance.

References

  1. Cheng KL, Nafziger AN, Peloquin CA, Amsden GW (1998) "Effect of grapefruit juice on clarithromycin pharmacokinetics." Antimicrob Agents Chemother, 42, p. 927-9

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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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