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Drug Interactions between lurbinectedin and Wilzin

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

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Interactions between your drugs

Minor

zinc acetate lurbinectedin

Applies to: Wilzin (zinc acetate) and lurbinectedin

Theoretically, agents that are thought to have immunostimulant properties such as echinacea, vitamin E, cat's claw, and zinc may antagonize the pharmacologic effects of immunosuppressants. However, clinical cases of drug interactions have not been reported.

References

  1. Miller LG (1998) "Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions." Arch Intern Med, 158, p. 2200-11
  2. Pepping J (1999) "Echinacea." Am J Health Syst Pharm, 56, p. 121-2
  3. Izzo AA, Ernst E (2001) "Interactions between herbal medicines and prescribed drugs: a systematic review." Drugs, 61, p. 2163-75
  4. Therapeutic Research Faculty (2008) Natural Medicines Comprehensive Database. http://www.naturaldatabase.com
  5. (2024) "Product Information. Ashwagandha (ashwagandha)." Now Foods, 1
  6. (2024) "Product Information. Vyvgart (efgartigimod alfa)." Argenx UK Ltd
  7. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health Office of Dietary Supplements Ashwagandha https://www.nccih.nih.gov/health/ashwagandha
View all 7 references

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Drug and food interactions

Major

lurbinectedin food

Applies to: lurbinectedin

GENERALLY AVOID: Grapefruit and Seville oranges may increase the plasma concentrations of lurbinectedin. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit and Seville oranges. Inhibition of hepatic CYP450 3A4 may also contribute. The interaction has not been studied with grapefruit or Seville oranges, but pharmacokinetic data are available for potent and moderate CYP450 3A4 inhibitors. In a clinical drug interaction study, coadministration of itraconazole, a potent CYP450 3A4 inhibitor, increased the systemic exposure (AUC) of total lurbinectedin by 2.7-fold and unbound lurbinectedin by 2.4-fold. In a Phase 1 study, coadministration of aprepitant, a moderate CYP450 3A4 inhibitor, decreased lurbinectedin plasma clearance by 33% compared to lurbinectedin alone. In general, the effect of grapefruit and Seville oranges is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice and Seville oranges (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. Increased exposure may increase the incidence and severity of adverse reactions of lurbinectedin, such as myelosuppression and hepatotoxicity.

MANAGEMENT: Patients should avoid consumption of grapefruit, grapefruit juice, and Seville oranges during treatment with lurbinectedin.

References

  1. (2020) "Product Information. Zepzelca (lurbinectedin)." Jazz Pharmaceuticals

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Moderate

zinc acetate food

Applies to: Wilzin (zinc acetate)

ADJUST DOSING INTERVAL: The presence of certain foods (e.g., bread, bran, hard boiled eggs, coffee, and milk) may significantly delay the absorption of zinc acetate. Fibres, phytates, and other substances in food prevent zinc from entering intestinal cells by binding with it. Protein does not appear to interfere with its absorption.

MANAGEMENT: Zinc acetate should preferably be taken on an empty stomach, at least one hour before or two to three hours after meals. It may be taken with small amounts of protein such as meat.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."

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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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.