Interactions between Ambrisentan and Venclexta

Ambrisentan has a moderate potential interaction with Anemia.

Clinical studies have shown that most endothelin receptor antagonists decrease hemoglobin concentration and hematocrit levels. There are some postmarketing reports of anemia cases which needed blood transfusion. Hemoglobin and hematocrit levels should be measured prior to treatment initiation and should be monitored periodically thereafter. Initiation of therapy is not recommended in patients with clinically significant anemia.

The venetoclax in Venclexta has a moderate potential interaction with Fever.

Venetoclax can cause neutropenia. It is recommended to monitor for fever and signs suggestive of an infection. Monitor complete blood count during the course of therapy and reduce dose or interrupt treatment for severe neutropenia. Therapy with this agent should be administered cautiously in patients with preexisting bone marrow depression or blood dyscrasias.

Ambrisentan has a moderate potential interaction with Heart Failure.

Peripheral edema and fluid retention are known clinical consequences of pulmonary hypertension and also known effects of endothelin receptor antagonists. Caution and monitoring is recommended if these agents are used in patients with underlying left ventricular dysfunction or underlying heart failure, as they have an increased risk for developing significant fluid retention that may need treatment or require discontinuation.

The venetoclax in Venclexta has a moderate potential interaction with Infection.

Venetoclax can cause neutropenia. It is recommended to monitor for fever and signs suggestive of an infection. Monitor complete blood count during the course of therapy and reduce dose or interrupt treatment for severe neutropenia. Therapy with this agent should be administered cautiously in patients with preexisting bone marrow depression or blood dyscrasias.

Ambrisentan has a major potential interaction with Liver Disease.

Endothelin receptor antagonists (ERAs) have been associated with aminotransferase elevations, hepatotoxicity, and cases of liver failure. Hepatic function should be assessed before treatment initiation and closely monitored during treatment. Therapy should be discontinued if aminotransferase elevations are accompanied by increases in bilirubin, or clinical symptoms of hepatotoxicity such as nausea, vomiting, fever, abdominal pain or jaundice. Treatment should be avoided in patients with elevated aminotransferases at baseline as monitoring for hepatotoxicity may be more difficult. In general, the use of ERAs is not recommended for patients with moderate to severe hepatic impairment.

The venetoclax in Venclexta has a moderate potential interaction with Liver Disease.

In vitro studies demonstrated that venetoclax is predominantly metabolized in the liver by CYP450 3A4/5. Based on pharmacokinetic analysis with subjects with mild and moderate hepatic impairment, the venetoclax exposures were similar to those with normal hepatic function; therefore, no dose adjustment is recommended in patients with mild or moderate hepatic impairment. Based on the drug metabolism, an increase in adverse events might result in patients with moderate to severe hepatic impairment. It is recommended to monitor patients with moderate to severe hepatic impairment carefully for signs of toxicity during the initiation and the weekly dose ramp-up phase. Caution is advised when using this agent in patients with severe hepatic impairment as it pharmacokinetics has not been studied.

The venetoclax in Venclexta has a moderate potential interaction with Neutropenia.

Venetoclax can cause neutropenia. It is recommended to monitor for fever and signs suggestive of an infection. Monitor complete blood count during the course of therapy and reduce dose or interrupt treatment for severe neutropenia. Therapy with this agent should be administered cautiously in patients with preexisting bone marrow depression or blood dyscrasias.

Ambrisentan has a moderate potential interaction with Renal Dysfunction.

There is no information on the exposure to ambrisentan in patients with severe renal impairment. Additionally, the impact of hemodialysis on the disposition of ambrisentan has not been studied, hence caution is advised. No dosage adjustment is required in patients with mild or moderate renal impairment.

The venetoclax in Venclexta has a moderate potential interaction with Renal Dysfunction.

Based on pharmacokinetic analysis with subjects with mild and moderate renal impairment, the venetoclax exposures were similar to those with normal renal function; therefore, no dose adjustment is recommended in these patients. The pharmacokinetics of venetoclax has not been studied in subjects with severe renal impairment. Patients with reduced renal function are at increased risk of tumor lysis syndrome (TLS) and these patients may require more intensive monitoring and care to reduce the risk of TLS at the start of treatment. Patients should be assessed for risk factor that may contribute to an increase risk for TLS and complete blood chemistries should be monitored regularly. Dose interruption is recommended if needed based on clinical findings.

The venetoclax in Venclexta has a moderate potential interaction with Tumor Lysis Syndrome.

Based on pharmacokinetic analysis with subjects with mild and moderate renal impairment, the venetoclax exposures were similar to those with normal renal function; therefore, no dose adjustment is recommended in these patients. The pharmacokinetics of venetoclax has not been studied in subjects with severe renal impairment. Patients with reduced renal function are at increased risk of tumor lysis syndrome (TLS) and these patients may require more intensive monitoring and care to reduce the risk of TLS at the start of treatment. Patients should be assessed for risk factor that may contribute to an increase risk for TLS and complete blood chemistries should be monitored regularly. Dose interruption is recommended if needed based on clinical findings.

The venetoclax in Venclexta has a moderate potential interaction with Vaccination.

The administration of live attenuated vaccines should be avoided prior to, during, and after therapy with venetoclax until B-cell recovery occurs. It is recommended to be up-to-date with all required immunizations, as recommended by current immunization guidelines, before initiating therapy. The safety and efficacy of immunization with live attenuated vaccines during or following venetoclax therapy have not been studied. Venetoclax may interfere with the response to immunization and the vaccinations may be less effective.