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Drug Interactions between istradefylline and Zytiga

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

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Interactions between your drugs

Moderate

abiraterone istradefylline

Applies to: Zytiga (abiraterone) and istradefylline

MONITOR: Coadministration with moderate inhibitors of CYP450 3A4 may increase the plasma concentrations of istradefylline, which is primarily metabolized by CYP450 3A4 and 1A1. In study subjects, administration of a single 40 mg dose of istradefylline with the potent CYP450 3A4 inhibitor ketoconazole (200 mg twice daily for 4 days) increased the total systemic exposure (AUC(inf)) of istradefylline by 2.5-fold. No data are available regarding the effects that other, less potent CYP450 3A4 inhibitors will have on the pharmacokinetics of istradefylline.

MANAGEMENT: Caution is advised if istradefylline is used with moderate CYP450 3A4 inhibitors. It is unknown if istradefylline will require a dosage adjustment if coadministered with a moderate CYP450 3A4 inhibitor. Clinical and laboratory monitoring of istradefylline should be considered whenever a moderate CYP450 3A4 inhibitor is added to or withdrawn from therapy. Patients should be monitored for adverse effects including dyskinesia, impulse control issues, dizziness, constipation, nausea, hallucinations, and insomnia.

References

  1. (2019) "Product Information. Nourianz (istradefylline)." Kyowa Kirin, Inc

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Drug and food interactions

Moderate

abiraterone food

Applies to: Zytiga (abiraterone)

ADJUST DOSING INTERVAL: Food may significantly increase the oral bioavailability of some formulations of abiraterone acetate. Compared to administration in the fasted state, abiraterone peak plasma concentration (Cmax) and systemic exposure (AUC) were approximately 7- and 5-fold higher, respectively, when a single dose of abiraterone acetate was administered with a low-fat meal (7% fat; 300 calories) and approximately 17- and 10-fold higher, respectively, when it was administered with a high-fat meal (57% fat; 825 calories). Given the normal variation in the content and composition of meals, taking abiraterone acetate with meals has the potential to result in increased and highly variable exposures. The safety of these increased exposures during multiple dosing has not been assessed. However, the abiraterone acetate 125 mg tablet, commonly marketed as Yonsa, was found to have an approximately 6.5-fold higher Cmax and 4.4-fold higher AUC when a single dose of 500 mg (4 tablets) was administered with a high-fat meal (56% - 60% fat, 900 - 1000 calories) compared to overnight fasting in healthy volunteers. These differences were not considered clinically significant for this formulation.

MANAGEMENT: Some formulations of abiraterone acetate must be taken on an empty stomach. No food should be consumed for at least two hours before and one hour after the abiraterone acetate dose. However, the abiraterone acetate 125 mg tablet, commonly marketed as Yonsa, can be taken with or without food. The manufacturer's product labeling should be consulted for specific guidance.

References

  1. (2011) "Product Information. Zytiga (abiraterone)." Centocor Inc
  2. (2023) "Product Information. Akeega (abiraterone-niraparib)." Janssen Biotech, Inc.
  3. (2023) "Product Information. Akeega (abiraterone-niraparib)." Janssen Inc
  4. (2021) "Product Information. Zytiga (abiraterone)." Janssen Biotech, Inc.
  5. (2022) "Product Information. Yonsa (abiraterone)." Sun Pharmaceutical Industries
  6. (2023) "Product Information. Apo-Abiraterone (abiraterone)." Apotex Inc
  7. (2021) "Product Information. Zytiga (abiraterone)." Janssen-Cilag Pty Ltd
  8. (2023) "Product Information. Abiraterone (abiraterone)." Wockhardt UK Ltd
  9. (2023) "Product Information. Yonsa Mpred (abiraterone-methylprednisolone)." Sun Pharma ANZ Pty Ltd
View all 9 references

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Moderate

istradefylline food

Applies to: istradefylline

ADJUST DOSE: Smoking tobacco may decrease the steady-state systemic exposure of istradefylline by 38% to 54%.

MANAGEMENT: The possibility of reduced therapeutic effects of istradefylline should be considered in smokers. The manufacturer recommends an istradefylline dosage of 40 mg once daily in patients who smoke 20 or more cigarettes (or the equivalent amount of another tobacco product) per day.

References

  1. (2019) "Product Information. Nourianz (istradefylline)." Kyowa Kirin, 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

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