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Drug Interactions between amprenavir and ruxolitinib topical

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

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Interactions between your drugs

Moderate

amprenavir ruxolitinib topical

Applies to: amprenavir and ruxolitinib topical

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 may increase plasma concentrations (Cmax) and systemic exposure (AUC) of topical ruxolitinib, which is primarily metabolized by the isoenzyme. Following administration of ketoconazole (200 mg twice daily for four days), a potent CYP450 3A4 inhibitor, healthy subjects then received a single dose of ruxolitinib (10 mg orally). The Cmax and AUC of ruxolitinib increased 33% and 91% respectively, compared to healthy subjects receiving the oral ruxolitinib dose alone. Increased exposure to ruxolitinib may increase the risk of adverse events. However, clinical data for topical ruxolitinib are not available.

MANAGEMENT: Concomitant use of topical ruxolitinib with potent inhibitors of CYP450 3A4 should generally be avoided. It may be advisable to monitor patients for the development of adverse effects. Consultation with individual package labeling, as well as relevant institutional protocols, may be advisable for further guidance.

References (2)
  1. (2024) "Product Information. Opzelura (ruxolitinib topical)." Incyte Corporation
  2. (2024) "Product Information. Opzelura (ruxolitinib topical)." Incyte Corporation, 2

Drug and food interactions

Major

ruxolitinib topical food

Applies to: ruxolitinib topical

MONITOR CLOSELY: Smoking during treatment with topical ruxolitinib may increase the risk of major adverse cardiovascular events (MACE) and the risk of developing malignancies, including lymphomas. During clinical trials, patients who were current or past smokers and received oral Janus Kinase (JAK) inhibitors to treat inflammatory conditions had an additional increased risk of overall malignancies. Additionally, oral JAK inhibitors reportedly increase patients' risk of MACE, including cardiovascular death, myocardial infarction, and stroke, particularly in patients who are current or past smokers or patients with other cardiovascular risk factors.

MANAGEMENT: The potential risks and benefits of topical ruxolitinib should be carefully weighed prior to initiating therapy, particularly in patients with cardiovascular risk factors, as well as those with a history of malignancy, those who develop a malignancy while on treatment, and/or patients who are current or past smokers. Patients should be informed about the symptoms of serious cardiovascular events and the steps to take if they occur. The manufacturer recommends discontinuing topical ruxolitinib in patients who have experienced a myocardial infarction or stroke.

References (2)
  1. (2024) "Product Information. Opzelura (ruxolitinib topical)." Incyte Corporation
  2. (2024) "Product Information. Opzelura (ruxolitinib topical)." Incyte Corporation, 2
Moderate

amprenavir food

Applies to: amprenavir

GENERALLY AVOID: Administration with a high-fat meal may decrease the oral bioavailability of amprenavir. The mechanism is unknown. In healthy volunteers, consumption of a standardized high-fat meal decreased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of amprenavir (1200 mg single oral dose) by 36% and 21%, respectively, compared to administration in the fasted state. The time to reach Cmax (Tmax) was increased 44% following a high-fat meal.

Grapefruit juice does not appear to significantly affect the pharmacokinetics of amprenavir. In 12 healthy volunteers, administration with grapefruit juice (200 mL) decreased the mean peak plasma concentration (Cmax) of amprenavir (1200 mg single oral dose) by 22% compared to water. The median time to reach Cmax (Tmax) was prolonged from 0.75 to 1.13 hours. These pharmacokinetic changes are not thought to be clinically significant, since antiretroviral response is more closely associated with systemic exposure (AUC) and trough plasma concentration (Cmin), which were not affected in the study.

MANAGEMENT: Amprenavir may be taken with or without food, but should not be taken with a high-fat meal.

References (2)
  1. (2001) "Product Information. Agenerase (amprenavir)." Glaxo Wellcome
  2. Demarles D, Gillotin C, Bonaventure-Paci S, Vincent I, Fosse S, Taburet AM (2002) "Single-dose pharmacokinetics of amprenavir coadministered with grapefruit juice." Antimicrob Agents Chemother, 46, p. 1589-1590

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

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