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Drug Interactions between Menorest and Pomalyst

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

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Interactions between your drugs

Major

estradiol pomalidomide

Applies to: Menorest (estradiol) and Pomalyst (pomalidomide)

MONITOR CLOSELY: Concomitant treatment with agents that can cause thrombosis such as erythropoiesis- or thrombopoiesis-stimulating agents, estrogens, selective estrogen receptor modulators, or C1 esterase inhibitors may potentiate the risk of venous thromboembolic events associated with the use of pomalidomide. Deep venous thrombosis (DVT) and pulmonary embolism (PE) occur in patients with multiple myeloma treated with pomalidomide. All patients in the premarketing clinical trial were required to receive prophylactic antithrombotic treatment (81% aspirin, 16% warfarin, 21% heparin, 3% clopidogrel). The rate of DVT or PE was 3%.

MANAGEMENT: Agents that are known to cause thrombosis should be used with caution in multiple myeloma patients receiving pomalidomide. Prophylactic antithrombotic measures should be considered after assessing underlying risk factors such as health history and concomitant medications. Patients should be advised to seek medical attention if they develop potential signs and symptoms of thromboembolism such as chest pain; shortness of breath; rapid pulse; pain, swelling, and/or discoloration in an arm or leg; and numbness or weakness on one side of the body.

References

  1. "Product Information. Pomalyst (pomalidomide)." QLT Phototherapeutics Inc (2013):

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Drug and food interactions

Moderate

pomalidomide food

Applies to: Pomalyst (pomalidomide)

MONITOR: Cigarette smoking may reduce pomalidomide exposure due to induction of CYP450 1A2, the isoenzyme that is responsible for the metabolic clearance of pomalidomide along with CYP450 3A4.

MANAGEMENT: Patients should be advised that smoking may reduce the efficacy of pomalidomide therapy. Pomalidomide should be taken on an empty stomach, at least 2 hours before or 2 hours after a meal.

References

  1. "Product Information. Pomalyst (pomalidomide)." QLT Phototherapeutics Inc (2013):

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Minor

estradiol food

Applies to: Menorest (estradiol)

Coadministration with grapefruit juice may increase the bioavailability of oral estrogens. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall induced by certain compounds present in grapefruits. In a small, randomized, crossover study, the administration of ethinyl estradiol with grapefruit juice (compared to herbal tea) increased peak plasma drug concentration (Cmax) by 37% and area under the concentration-time curve (AUC) by 28%. Based on these findings, grapefruit juice is unlikely to affect the overall safety profile of ethinyl estradiol. However, as with other drug interactions involving grapefruit juice, the pharmacokinetic alterations are subject to a high degree of interpatient variability. Also, the effect on other estrogens has not been studied.

References

  1. Weber A, Jager R, Borner A, et al. "Can grapefruit juice influence ethinyl estradiol bioavailability?" Contraception 53 (1996): 41-7
  2. Schubert W, Eriksson U, Edgar B, Cullberg G, Hedner T "Flavonoids in grapefruit juice inhibit the in vitro hepatic metabolism of 17B-estradiol." Eur J Drug Metab Pharmacokinet 20 (1995): 219-24

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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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