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Drug Interactions between acalabrutinib and Lamprene

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

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Interactions between your drugs

Major

clofazimine acalabrutinib

Applies to: Lamprene (clofazimine) and acalabrutinib

Consumer information for this interaction is not currently available.

ADJUST DOSE: Coadministration with moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of acalabrutinib, which is primarily metabolized by the isoenzyme. Physiologically based pharmacokinetic (PBPK) simulations showed that moderate CYP450 3A4 inhibitors (erythromycin, fluconazole, diltiazem) increased acalabrutinib peak plasma concentration (Cmax) and systemic exposure (AUC) by 2- to nearly 3-fold. In healthy subjects, administration of acalabrutinib with the moderate CYP450 3A4 inhibitors fluconazole (400 mg as a single dose) or isavuconazole (200 mg as a repeated dose for 5 days) increased acalabrutinib Cmax and AUC by 1.4- to 2-fold, while the Cmax and AUC of the active metabolite, ACP-5862, was decreased by 0.65- to 0.88-fold. Increased acalabrutinib exposure may potentiate the risk of toxicities such as hemorrhage, infection, cytopenias, malignancies, and atrial fibrillation or flutter.

MANAGEMENT: Caution and close monitoring for signs of toxicity are advisable if acalabrutinib is used with moderate CYP450 3A4 inhibitors. The manufacturer recommends reducing the dosage of acalabrutinib to 100 mg once daily when coadministered with moderate CYP450 3A4 inhibitors, although some experts suggest this may not be necessary. Refer to the product labeling for guidance on acalabrutinib dosage adjustments and treatment interruption or discontinuation should Grade 3 or 4 adverse reactions occur.

References

  1. (2019) "Product Information. Calquence (acalabrutinib)." AstraZeneca Pty Ltd
  2. (2023) "Product Information. Calquence (acalabrutinib)." AstraZeneca Canada Inc
  3. (2021) "Product Information. Calquence (acalabrutinib)." AstraZeneca UK Ltd
  4. (2022) "Product Information. Calquence (acalabrutinib)." Astra-Zeneca Pharmaceuticals
  5. Chen B, Zhou D, Wei H, et al. (2022) "Acalabrutinib CYP3A-mediated drug-drug interactions: clinical evaluations and physiologically based pharmacokinetic modelling to inform dose adjustment strategy" Br J Clin Pharmacol, 88, p. 3716-29
View all 5 references

Drug and food interactions

Major

acalabrutinib food

Applies to: acalabrutinib

Acalabrutinib may be taken with or without food. However, consumption of grapefruit and grapefruit juice can increase the blood levels of acalabrutinib. This may increase side effects such as nausea, vomiting, diarrhea, abdominal pain, hemorrhage, development of other cancers, abnormal heart rhythm, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. You should avoid the consumption of grapefruit and grapefruit juice during treatment with acalabrutinib. Be sure to take the medication at approximately the same time(s) every day to maintain consistent blood levels and effects. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. 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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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.