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Drug Interactions between Doxil and sorafenib

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

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Interactions between your drugs

Moderate

DOXOrubicin liposomal SORAfenib

Applies to: Doxil (doxorubicin liposomal) and sorafenib

MONITOR: Coadministration with sorafenib may increase the plasma concentrations of doxorubicin. The mechanism of interaction has not been described, but may involve inhibition of P-glycoprotein efflux transporter by sorafenib. In a phase I study, concomitant use of doxorubicin (60 mg/m2 every 21 days) with sorafenib (400 mg twice daily, administered with a 3-day break in dosing around administration of doxorubicin) increased the mean peak plasma concentration (Cmax) of doxorubicin by 103% and systemic exposure (AUC) by 47%, but had no apparent impact on clinical toxicity such as myelosuppression or cardiotoxicity. No significant pharmacokinetic changes were observed in patients given lower dosages of sorafenib (100 mg or 200 mg twice daily), and sorafenib pharmacokinetics were not significantly altered by doxorubicin in the study. By contrast, a 21% increase in the AUC of doxorubicin has been cited in the sorafenib labeling.

MANAGEMENT: Caution may be advisable when doxorubicin is used with sorafenib. Patients should be monitored closely for potential toxicities of doxorubicin such as mucositis, myelosuppression and cardiotoxicity, and the dosage adjusted accordingly.

References

  1. (2001) "Product Information. Doxil (doxorubicin liposomal)." Sequus Pharmaceuticals Inc
  2. (2005) "Product Information. Nexavar (sorafenib)." Bayer Pharmaceutical Inc
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  4. Richly H, Henning BF, Kupsch P, et al. (2006) "Results of a Phase I trial of sorafenib (BAY 43-9006) in combination with doxorubicin in patinets with refractory solid tumors." Ann Oncol, 17, p. 866-73
View all 4 references

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Drug and food interactions

Moderate

SORAfenib food

Applies to: sorafenib

ADJUST DOSING INTERVAL: Food may reduce the oral absorption and bioavailability of sorafenib. According to the product labeling, sorafenib bioavailability was reduced by 29% when administered with a high-fat meal compared to administration in the fasted state. When given with a moderate-fat meal, bioavailability was similar to that in the fasted state.

MANAGEMENT: To ensure maximal and consistent oral absorption, sorafenib should be taken at least one hour before or two hours after eating.

References

  1. (2005) "Product Information. Nexavar (sorafenib)." Bayer Pharmaceutical Inc

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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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