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Drug Interactions between atazanavir / cobicistat and fosnetupitant / palonosetron

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

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Interactions between your drugs

Minor

atazanavir fosnetupitant

Applies to: atazanavir / cobicistat and fosnetupitant / palonosetron

Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of netupitant. When a single 300 mg-0.5 mg dose of netupitant-palonosetron was administered following 400 mg once daily administration of the potent CYP450 3A4 inhibitor ketoconazole for 12 days, mean netupitant peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 25% and 140%, respectively, while mean Cmax and AUC of palonosetron increased by 15% and 10%, respectively. No dosage adjustment is necessary for single-dose administration of netupitant-palonosetron when used with potent CYP450 3A4 inhibitors. However, patients may experience increased adverse effects such as headache, asthenia, dyspepsia, fatigue, constipation, and erythema.

References

  1. (2014) "Product Information. Akynzeo (netupitant-palonosetron)." Eisai Inc

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Minor

cobicistat fosnetupitant

Applies to: atazanavir / cobicistat and fosnetupitant / palonosetron

Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of netupitant. When a single 300 mg-0.5 mg dose of netupitant-palonosetron was administered following 400 mg once daily administration of the potent CYP450 3A4 inhibitor ketoconazole for 12 days, mean netupitant peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 25% and 140%, respectively, while mean Cmax and AUC of palonosetron increased by 15% and 10%, respectively. No dosage adjustment is necessary for single-dose administration of netupitant-palonosetron when used with potent CYP450 3A4 inhibitors. However, patients may experience increased adverse effects such as headache, asthenia, dyspepsia, fatigue, constipation, and erythema.

References

  1. (2014) "Product Information. Akynzeo (netupitant-palonosetron)." Eisai Inc

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Drug and food interactions

Moderate

atazanavir food

Applies to: atazanavir / cobicistat

ADJUST DOSING INTERVAL: Administration of atazanavir with food enhances oral bioavailability and reduces pharmacokinetic variability. According to the manufacturer, administration with a light meal increased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of a single 400 mg dose of atazanavir by 57% and 70%, respectively, relative to the fasting state. Administration with a high-fat meal resulted in a mean increase of 35% in atazanavir AUC and no change in Cmax compared to fasting. The coefficient of variation of AUC and Cmax decreased by approximately one-half when given with either a light or high-fat meal compared to the fasting state.

MANAGEMENT: To ensure maximal oral absorption, atazanavir should be administered with or immediately after a meal.

References

  1. (2003) "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb

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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.

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.

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