Skip to Content

Xalkori (crizotinib) Disease Interactions

There are 5 disease interactions with Xalkori (crizotinib):

Moderate

Crizotinib (Includes Xalkori) ↔ Bradycardia

Moderate Potential Hazard, Moderate plausibility

Applies to: Arrhythmias

Crizotinib can cause symptomatic bradycardia. It is recommended to monitor heart rate and blood pressure regularly. It might be necessary to withhold crizotinib in cases of symptomatic bradycardia that is not life-threatening until recovery occurs and then resume treatment at an appropriate dose. Permanently discontinue therapy for life-threatening bradycardia due to crizotinib treatment; however, if associated with concomitant medications known to cause bradycardia or hypotension, hold crizotinib until recovery and if concomitant medications can be adjusted or discontinued, restart treatment with crizotinib at 250 mg once daily with frequent monitoring. Close monitoring is recommended.

Moderate

Crizotinib (Includes Xalkori) ↔ Hepatic Impairment

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Crizotinib is extensively metabolized in the liver, and hepatic impairment is likely to increase plasma crizotinib concentrations. Cases of drug-induced hepatotoxicity with fatal outcomes have been reported with the use of crizotinib. It is recommended to monitor liver function tests, regularly as clinically indicated, with more frequent repeat testing for increased liver transaminases, alkaline phosphatase, or total bilirubin in patients who develop transaminase elevations and to temporarily suspend, reduce the dose, or permanently discontinue therapy as per recommended by the manufacturer. Caution is recommended in patients with hepatic impairment.

Moderate

Crizotinib (Includes Xalkori) ↔ Renal Impairment

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

Based on a population pharmacokinetic analysis of crizotinib no starting dose adjustment is needed for patients with mild or moderate renal impairment. Care should be exercised when using this agent in patients with severe renal impairment as the exposure to crizotinib is increased in these patients. It is recommended to administer crizotinib at a dose of 250 mg taken orally once daily in patients with severe renal impairment not requiring dialysis.

Moderate

Crizotinib (Includes Xalkori) ↔ Visual Loss

Moderate Potential Hazard, Moderate plausibility

Applies to: Visual Defect/Disturbance

Cases of optic atrophy and optic nerve disorder leading to vision loss have been reported with the use of crizotinib. It is recommended to perform an ophthalmological evaluation consisting of best corrected visual acuity, retinal photographs, visual fields, optical coherence tomography (OCT) and other evaluations as appropriate for new onset of severe visual loss. Discontinue crizotinib in patients with new onset of severe visual loss. There is insufficient information to characterize the risks of resumption of crizotinib in patients with a severe visual loss; a decision to resume treatment with crizotinib should consider the potential benefits to the patient. Care should be exercised when prescribing crizotinib in these patients.

Moderate

Multikinase Inhibitors (Includes Xalkori) ↔ Lung Toxicity

Moderate Potential Hazard, Moderate plausibility

Applies to: Interstitial Pneumonitis, Pulmonary Impairment

The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, permanently discontinue these agents and institute appropriate measures. Immediately withhold treatment in patients diagnosed with ILD/pneumonitis and permanently discontinue therapy if no other potential causes of ILD/pneumonitis have been identified.

Xalkori (crizotinib) drug Interactions

There are 679 drug interactions with Xalkori (crizotinib)

Xalkori (crizotinib) alcohol/food Interactions

There is 1 alcohol/food interaction with Xalkori (crizotinib)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
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 information available.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2017 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

Hide