Drug Interactions between abemaciclib and dexamethasone / moxifloxacin

Moxifloxacin and other medications in its class can cause tendinitis and tendon rupture, and the risk may be increased when combined with a steroid such as dexAMETHasone. Older adults over 60 years of age and those who have received a kidney, heart, and/or lung transplant may be particularly susceptible. Tendon rupture can occur during or up to several months after finishing moxifloxacin treatment and may require surgery or result in prolonged disability. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Stop taking moxifloxacin and call your doctor immediately if you experience pain, swelling, or inflammation of a tendon area such as the back of the ankle, shoulder, biceps, hand, or thumb. You should also avoid exercise or use of the affected area until further instruction from your doctor. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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GENERALLY AVOID: Coadministration with moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of abemaciclib and its pharmacologically active metabolites, all of which are substrates of the isoenzyme. Administration of the moderate CYP450 3A4 inducers efavirenz, bosentan, and modafinil are predicted to reduce the relative potency-adjusted unbound systemic exposure (AUC) of abemaciclib plus its active metabolites by 53%, 41%, and 29%, respectively. Reduced efficacy of abemaciclib may occur. In addition, when two or more medications with similar adverse effect profiles are given concurrently, the likelihood of experiencing these adverse reactions may be increased. For example, coadministration of abemaciclib with other agents that are also associated with liver damage (e.g., bosentan, efavirenz, nevirapine, pexidartinib, repotrectinib) may increase the risk of hepatotoxicity.

MANAGEMENT: Concomitant use of abemaciclib with moderate CYP450 3A4 inducers should generally be avoided. Alternative agents without CYP450 3A4 induction potential should be considered.