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Drug Interactions between alpelisib and idelalisib

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

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Interactions between your drugs

Moderate

idelalisib alpelisib

Applies to: idelalisib and alpelisib

GENERALLY AVOID: The risk and/or severity of diarrhea may be increased when idelalisib is used with other agents that cause diarrhea. In premarketing trials, serious and fatal diarrhea or colitis (Grade 3 or higher) occurred in 14% of patients receiving idelalisib. Diarrhea may occur at any time and responds poorly to antimotility agents. The median time to resolution across trials ranged from one week to one month following interruption of idelalisib therapy and, in some instances, use of corticosteroids. Serious and fatal intestinal perforation has also been reported with idelalisib. At the time of perforation, some patients had moderate to severe diarrhea.

MANAGEMENT: Concomitant use of idelalisib with other drugs that cause diarrhea should be avoided whenever possible. Patients treated with idelalisib should be monitored for development of severe diarrhea or colitis during treatment in accordance with the product labeling, and the dosing adjusted or interrupted as necessary. Permanent discontinuation of idelalisib is recommended in those who experience life-threatening diarrhea or intestinal perforation. Patients should be advised to contact their physician immediately if the number of bowel movements per day increases by six or more, and to promptly report any new or worsening abdominal pain, chills, fever, nausea, or vomiting.

References (1)
  1. (2014) "Product Information. Zydelig (idelalisib)." Gilead Sciences

Drug and food interactions

Moderate

alpelisib food

Applies to: alpelisib

ADJUST DOSING INTERVAL: Food significantly enhances the oral absorption and bioavailability of alpelisib. When administered with a high-fat high-calorie meal (985 calories with 58.1 g of fat) or a low-fat low-calorie meal (334 calories with 8.7 g of fat) the AUC and Cmax of a single dose of alpelisib was increased by 73% and 84% and 77% and 145%, respectively. There were no clinically significant differences in alpelisib AUC between the two types of meals. In addition, food appears to have a more pronounced effect on the solubility of alpelisib than gastric pH. When coadministered with a single 300 mg dose of alpelisib, ranitidine decreased the absorption and overall exposure of alpelisib. Following administration of ranitidine with a low-fat low-calorie meal, the mean AUC and Cmax of alpelisib was decreased by 21% and 36%, respectively. Administration of ranitidine under fasting conditions reduced the mean AUC and Cmax of alpelisib by 30% and 51%, respectively.

MANAGEMENT: To ensure maximal oral absorption, alpelisib should be administered with a meal.

References (1)
  1. (2019) "Product Information. Piqray (alpelisib)." Novartis Pharmaceuticals

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Pi3k inhibitors

Therapeutic duplication

The recommended maximum number of medicines in the 'PI3K inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'PI3K inhibitors' category:

  • alpelisib
  • idelalisib

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

See also

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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.

Medical Disclaimer