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Drug Interactions between Braftovi and Rexulti

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

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Interactions between your drugs

Major

brexpiprazole encorafenib

Applies to: Rexulti (brexpiprazole) and Braftovi (encorafenib)

ADJUST DOSE: Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of brexpiprazole. In vitro and in vivo data indicate that brexpiprazole is metabolized primarily by CYP450 3A4 and 2D6. When a single 4 mg oral dose of brexpiprazole was administered to healthy study subjects treated with the potent CYP450 3A4 inducer rifampin at 600 mg twice daily for 12 days, mean brexpiprazole peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 31% and 73%, respectively, compared to administration of brexpiprazole alone. Reduced efficacy of brexpiprazole may occur.

MANAGEMENT: The prescribing information for brexpiprazole recommends doubling the usual dosage over 1 to 2 weeks following the addition of a potent CYP450 3A4 inducer. Additional dosage adjustments should be based on clinical evaluation. Upon discontinuation of the inducer, brexpiprazole dosage should be reduced to the original level over 1 to 2 weeks.

References

  1. (2023) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
  2. (2020) "Product Information. Rexulti (brexpiprazole)." Otsuka Pharmaceutical Co Ltd
  3. (2020) "Product Information. Rexulti (brexpiprazole)." Lundbeck Australia Pty Ltd

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Drug and food interactions

Major

encorafenib food

Applies to: Braftovi (encorafenib)

GENERALLY AVOID: Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of encorafenib, which is primarily metabolized by the isoenzyme. When a single 50 mg dose of encorafenib (equivalent to 0.1 times the recommended dose) was administered with posaconazole, a potent CYP450 3A4 inhibitor, encorafenib peak plasma concentration (Cmax) increased by 68% and systemic exposure (AUC) increased by 3-fold. When the same dose of encorafenib was administered with diltiazem, a moderate CYP450 3A4 inhibitor, encorafenib Cmax increased by 45% and AUC increased by 2-fold. Increased exposure to encorafenib may increase the risk of serious and life-threatening adverse effects such as hemorrhage, uveitis, QT prolongation, hepatotoxicity, dermatologic reactions, and new malignancies.

MANAGEMENT: Concomitant use of encorafenib with grapefruit or grapefruit juice should generally be avoided. If coadministration is required, the manufacturer recommends reducing the encorafenib dose to one-third of the dose used prior to addition of a potent CYP450 3A4 inhibitor or one-half of the dose used prior to addition of a moderate CYP450 3A4 inhibitor. After the inhibitor has been discontinued for 3 to 5 elimination half-lives, the encorafenib dose that was taken prior to initiating the inhibitor may be resumed.

References

  1. (2018) "Product Information. Braftovi (encorafenib)." Array BioPharma Inc.

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Moderate

brexpiprazole food

Applies to: Rexulti (brexpiprazole)

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

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
View all 4 references

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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

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