Drug Interactions between Epitol and mobocertinib
This report displays the potential drug interactions for the following 2 drugs:
- Epitol (carbamazepine)
- mobocertinib
Interactions between your drugs
carBAMazepine mobocertinib
Applies to: Epitol (carbamazepine) and mobocertinib
GENERALLY AVOID: Coadministration with strong or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations and anti-cancer activity of mobocertinib, which is primarily metabolized by the isoenzyme. Based on drug interaction studies using model-informed approaches, coadministration of mobocertinib with multiple doses of rifampin (a strong CYP450 3A4 inducer) is predicted to decrease the steady-state combined molar AUC (systemic exposure) of mobocertinib and its active metabolites by 92%, while coadministration with multiple doses of efavirenz (a moderate CYP450 3A4 inducer) is predicted to decrease this value by 58%.
MANAGEMENT: Coadministration of mobocertinib with strong or moderate CYP450 3A4 inducers should be avoided.
References
- (2021) "Product Information. Exkivity (mobocertinib)." Takeda Pharmaceuticals America
- (2022) "Product Information. Exkivity (mobocertinib)." Takeda UK Ltd
- (2022) "Product Information. Exkivity (mobocertinib)." Takeda Pharmaceuticals Australia Pty Ltd, EXKIVITY PI V1.0 (CC
Drug and food interactions
mobocertinib food
Applies to: mobocertinib
GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of mobocertinib. The mechanism may involve 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. Based on drug interaction studies using model-informed approaches, coadministration of mobocertinib with multiple doses of itraconazole or ketoconazole (strong CYP450 3A4 inhibitors) is predicted to increase the steady-state combined molar AUC (systemic exposure) of mobocertinib and its active metabolites by 374% to 419%, while coadministration with multiple doses of a moderate CYP450 3A4 inhibitor is predicted to increase this value by approximately 100% to 200%. 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. Elevated plasma concentrations of mobocertinib may increase the risk for adverse effects such as QT prolongation, heart failure or reduced ejection fraction, cardiomyopathy, heart block, diarrhea, rash, stomatitis, fatigue, and musculoskeletal pain.
MANAGEMENT: Patients should avoid consumption of grapefruit and grapefruit juice during treatment with mobocertinib.
References
- (2021) "Product Information. Exkivity (mobocertinib)." Takeda Pharmaceuticals America
- (2022) "Product Information. Exkivity (mobocertinib)." Takeda UK Ltd
carBAMazepine food
Applies to: Epitol (carbamazepine)
GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of carbamazepine. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.
In a small, randomized, crossover study, the administration of carbamazepine with grapefruit juice (compared to water) increased plasma drug concentrations by approximately 40%. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits.
MANAGEMENT: Patients receiving carbamazepine should be advised to avoid or limit consumption of alcohol. Given the drug's narrow therapeutic index, patients receiving carbamazepine therapy should preferably avoid the regular consumption of grapefruits and grapefruit juice to prevent any undue fluctuations in plasma drug levels. Patients should be advised to report signs of carbamazepine toxicity (nausea, visual disturbances, dizziness, or ataxia) to their physicians.
References
- (2002) "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals
- Garg SK, Kumar N, Bhargava VK, Prabhakar SK (1998) "Effect of grapefruit juice on carbamazepine bioavailability in patients with epilepsy." Clin Pharmacol Ther, 64, p. 286-8
- Bailey DG, Dresser GR, Kreeft JH, Munoz C, Freeman DJ, Bend JR (2000) "Grapefruit-felodipine interaction: Effect of unprocessed fruit and probable active ingredients." Clin Pharmacol Ther, 68, p. 468-77
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
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
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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