Can you take Akynzeo for Injection with Brigatinib?

Brigatinib has a moderate potential interaction with Interstitial Lung Disease.

Severe, life-threatening, and fatal pulmonary adverse reactions consistent with interstitial lung disease (ILD)/pneumonitis have occurred with the use of brigatinib. It is recommended to monitor for new or worsening respiratory symptoms (e.g., dyspnea, cough, etc.), particularly during the first week of initiating this drug. Withhold brigatinib in any patient with new or worsening respiratory symptoms, and promptly evaluate for ILD/pneumonitis or other causes of respiratory symptoms (e.g., pulmonary embolism, tumor progression, and infectious pneumonia). Dose modifications or permanent discontinuation may be necessary.

The palonosetron in Akynzeo for Injection has a moderate potential interaction with Liver Disease.

No dosage adjustment for palonosetron is necessary for patients with mild to moderate hepatic impairment (Child-Pugh score 5 to 8). Limited data are available in patients with severe hepatic impairment (Child-Pugh score greater than 9). It is recommended to avoid use of palonosetron in patients with severe hepatic impairment.

The fosnetupitant in Akynzeo for Injection has a moderate potential interaction with Liver Disease.

Limited data are available with fosnetupitant (only available in combination with palonosetron in the US) in patients with severe hepatic impairment (Child-Pugh score greater than 9), therefore, its use should be avoided in these patients. No dosage adjustment is necessary for patients with mild to moderate hepatic impairment (Child-Pugh score 5 to 8).

Brigatinib has a moderate potential interaction with Liver Disease.

Following a single dose of 90 mg, unbound brigatinib systemic exposure was 37% higher in subjects with severe hepatic impairment (Child-Pugh C) compared to subjects with normal hepatic function. It is recommended to reduce the dose by approximately 40% (i.e., from 180 mg to 120 mg, 120 mg to 90 mg, or from 90 mg to 60 mg) in these patients. No dose adjustment is recommended for patients with mild hepatic impairment (Child-Pugh A) or moderate hepatic impairment (Child-Pugh B).

Brigatinib has a moderate potential interaction with Pulmonary Impairment.

Severe, life-threatening, and fatal pulmonary adverse reactions consistent with interstitial lung disease (ILD)/pneumonitis have occurred with the use of brigatinib. It is recommended to monitor for new or worsening respiratory symptoms (e.g., dyspnea, cough, etc.), particularly during the first week of initiating this drug. Withhold brigatinib in any patient with new or worsening respiratory symptoms, and promptly evaluate for ILD/pneumonitis or other causes of respiratory symptoms (e.g., pulmonary embolism, tumor progression, and infectious pneumonia). Dose modifications or permanent discontinuation may be necessary.

The palonosetron in Akynzeo for Injection has a moderate potential interaction with Renal Dysfunction.

Mild to moderate renal impairment does not significantly affect palonosetron pharmacokinetic parameters. However, total systemic exposure increased approximately 28% in patients with severe renal impairment. Additionally, the pharmacokinetics of palonosetron have not been studied in patients with end-stage renal disease. Caution is advised.

The fosnetupitant in Akynzeo for Injection has a moderate potential interaction with Renal Dysfunction.

No dosage adjustment for netupitant/fosnetupitant (only available in combination with palonosetron in the US), is necessary in patients with mild to moderate renal impairment (creatinine clearance of 30 to 60 mL/min). The pharmacokinetics and safety of netupitant/fosnetupitant have not been studied in patients with severe renal impairment. Severe renal impairment (creatinine clearance < 30 mL/min) did not substantially affect pharmacokinetics of palonosetron. The pharmacokinetics for netupitant and palonosetron were not studied in patients with end-stage renal disease requiring hemodialysis, therefore, avoid the use of this drug in patients with severe renal impairment or end-stage renal disease.

Brigatinib has a moderate potential interaction with Renal Dysfunction.

Following a single dose of 90 mg, unbound brigatinib systemic exposure was 86% higher in subjects with severe renal impairment [creatinine clearance (CrCl) 15 to 29 mL/min] compared to subjects with normal renal function. It is recommended to reduce dose by approximately 50% (i.e., from 180 mg to 90 mg, or from 90 mg to 60 mg) in these patients. No dose adjustment is recommended for patients with mild or moderate renal impairment [creatinine clearance (CrCl) 30 to 89 mL/min].