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Drug Interactions between Akeega and revefenacin

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

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Interactions between your drugs

Moderate

abiraterone revefenacin

Applies to: Akeega (abiraterone / niraparib) and revefenacin

GENERALLY AVOID: Coadministration of revefenacin with inhibitors of organic anion transporting polypeptide (OATP) 1B1 and/or 1B3 may increase systemic exposure to its active metabolite, which has been reported to be a substrate of the hepatic uptake transporters. No pharmacokinetic data are available, but increased anticholinergic adverse effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary retention, constipation, and glaucoma (onset or exacerbation) may occur. In study patients, revefenacin was rapidly converted to its active metabolite following inhaled administration, and plasma exposures of the metabolite exceeded those of revefenacin by approximately 4- to 6-fold. The activity of the metabolite at target muscarinic receptors is approximately one-third to one-tenth that of revefenacin and could potentially contribute to systemic antimuscarinic effects at therapeutic doses.

MANAGEMENT: Concomitant use of revefenacin with OATP 1B1 and/or 1B3 inhibitors is not recommended.

References (3)
  1. (2018) "Product Information. Yupelri (revefenacin)." Mylan Specialty
  2. (2020) "Product Information. Nexlizet (bempedoic acid-ezetimibe)." Esperion Therapeutics
  3. (2020) "Product Information. Nexletol (bempedoic acid)." Esperion Therapeutics

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.