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Drug Interactions between Afinitor and Tybost

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

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Interactions between your drugs

Major

everolimus cobicistat

Applies to: Afinitor (everolimus) and Tybost (cobicistat)

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 and P-glycoprotein may significantly increase the plasma concentrations of everolimus following oral administration. Everolimus is a substrate of both the CYP450 3A4 isoenzyme and P-glycoprotein drug efflux transporter, thus their inhibition in the intestine can enhance the absorption of everolimus. The risk of side effects such as pneumonitis, stomatitis, infection, dyspnea, diarrhea, anemia, leucopenia, thrombocytopenia, hyperglycemia, and hyperlipidemia may be increased.

MANAGEMENT: Concomitant use of everolimus with potent inhibitors of CYP450 3A4 and P-glycoprotein should generally be avoided. Some authorities recommend avoiding concomitant use of everolimus during and for 2 weeks after treatment with itraconazole.

References

  1. "Product Information. Sporanox (itraconazole)." Janssen Pharmaceuticals PROD (2002):
  2. Cerner Multum, Inc. "Australian Product Information." O 0
  3. "Product Information. Afinitor (everolimus)." Novartis Pharmaceuticals (2009):
  4. Homma S, Takahashi KI, Nihei S, Kato F, Sugihara S, Nunoda S "The successful management of respiratory complications with long-term, low-dose macrolide administration in pediatric heart transplant recipients." Int Heart J (2014):
View all 4 references

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Drug and food interactions

Moderate

everolimus food

Applies to: Afinitor (everolimus)

GENERALLY AVOID: Grapefruit juice may significantly increase the plasma concentrations of orally administered everolimus. The mechanism is inhibition of CYP450 3A4 and P-glycoprotein activity in the gut wall by certain compounds present in grapefruit.

MANAGEMENT: Patients treated with everolimus should avoid consumption of grapefruit and grapefruit juice.

References

  1. "Product Information. Afinitor (everolimus)." Novartis Pharmaceuticals (2009):

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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.