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Drug Interactions between Iclusig and Ketek Pak

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

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Interactions between your drugs

Major

telithromycin PONATinib

Applies to: Ketek Pak (telithromycin) and Iclusig (ponatinib)

ADJUST DOSE: Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of ponatinib, which is a substrate of the isoenzyme. In 22 healthy volunteers, administration of a single 15 mg oral dose of ponatinib in combination with the potent CYP450 3A4 inhibitor ketoconazole (400 mg daily) increased ponatinib peak plasma concentration (Cmax) and systemic exposure (AUC) by 47% and 78%, respectively, compared to administration of ponatinib alone.

MANAGEMENT: Caution is recommended if concomitant use is required, and the dosage of ponatinib should be reduced according to the manufacturer's recommendations. Patients may be at increased risk for adverse effects such as thromboembolism, ischemia, congestive heart failure, hypertension, hepatotoxicity, pancreatitis, myelosuppression, hemorrhage, and fluid retention. Some authorities recommend that, following discontinuation and after an appropriate washout period of the CYP450 3A4 inhibitor (i.e., 3 to 5 half-lives), the ponatinib dosage taken prior to initiating the potent CYP450 3A4 inhibitor may be resumed (US).

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

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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