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Drug Interactions between Akeega and heparin flush

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

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Interactions between your drugs

Moderate

heparin flush niraparib

Applies to: heparin flush and Akeega (abiraterone / niraparib)

MONITOR: Concomitant use of heparin flush and drugs that interfere with platelet function or coagulation or drugs that commonly cause thrombocytopenia may potentiate the risk of bleeding complications. Although uncommon, inadvertent anticoagulation resulting in hemorrhagic events may occur with heparin flushes, particularly during repeated or excessive use or administration of higher concentration flush solutions.

MANAGEMENT: Caution and monitoring (e.g., platelet counts, hematocrits, tests for occult blood in stools) are advised when heparin flushes are given to patients receiving systemic anticoagulants, platelet inhibitors, antithrombotic agents, thrombolytics, or drugs with known risks of thrombocytopenia or bleeding. An unexplained fall in hematocrit, fall in blood pressure, or any other unexplained symptom should lead to serious consideration of a hemorrhagic event.

References (4)
  1. Passannante A, Macik BG (1988) "The heparin flush syndrome: a cause of iatrogenic hemorrhage." Am J Med Sci, 296, p. 71-3
  2. (2022) "Product Information. Heparin Sodium in Sodium Chloride (heparin flush)." Baxter Healthcare Corporation
  3. (2018) "Product Information. Canusal (heparin flush)." Wockhardt UK Ltd
  4. (2022) "Product Information. Heparinised Saline (Pfizer) (heparinised saline)." Pfizer Australia Pty Ltd, pfphepsi10922

Drug and food interactions

Moderate

abiraterone food

Applies to: Akeega (abiraterone / niraparib)

ADJUST DOSING INTERVAL: Food may significantly increase the oral bioavailability of some formulations of abiraterone acetate. Compared to administration in the fasted state, abiraterone peak plasma concentration (Cmax) and systemic exposure (AUC) were approximately 7- and 5-fold higher, respectively, when a single dose of abiraterone acetate was administered with a low-fat meal (7% fat; 300 calories) and approximately 17- and 10-fold higher, respectively, when it was administered with a high-fat meal (57% fat; 825 calories). Given the normal variation in the content and composition of meals, taking abiraterone acetate with meals has the potential to result in increased and highly variable exposures. The safety of these increased exposures during multiple dosing has not been assessed. However, the abiraterone acetate 125 mg tablet, commonly marketed as Yonsa, was found to have an approximately 6.5-fold higher Cmax and 4.4-fold higher AUC when a single dose of 500 mg (4 tablets) was administered with a high-fat meal (56% - 60% fat, 900 - 1000 calories) compared to overnight fasting in healthy volunteers. These differences were not considered clinically significant for this formulation.

MANAGEMENT: Some formulations of abiraterone acetate must be taken on an empty stomach. No food should be consumed for at least two hours before and one hour after the abiraterone acetate dose. However, the abiraterone acetate 125 mg tablet, commonly marketed as Yonsa, can be taken with or without food. The manufacturer's product labeling should be consulted for specific guidance.

References (8)
  1. (2023) "Product Information. Akeega (abiraterone-niraparib)." Janssen Biotech, Inc.
  2. (2023) "Product Information. Akeega (abiraterone-niraparib)." Janssen Inc
  3. (2021) "Product Information. Zytiga (abiraterone)." Janssen Biotech, Inc.
  4. (2022) "Product Information. Yonsa (abiraterone)." Sun Pharmaceutical Industries
  5. (2023) "Product Information. Apo-Abiraterone (abiraterone)." Apotex Inc
  6. (2021) "Product Information. Zytiga (abiraterone)." Janssen-Cilag Pty Ltd
  7. (2023) "Product Information. Abiraterone (abiraterone)." Wockhardt UK Ltd
  8. (2023) "Product Information. Yonsa Mpred (abiraterone-methylprednisolone)." Sun Pharma ANZ Pty Ltd

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.