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Drug Interactions between bazedoxifene / conjugated estrogens and carfilzomib

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

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Interactions between your drugs

Major

conjugated estrogens carfilzomib

Applies to: bazedoxifene / conjugated estrogens and carfilzomib

MONITOR CLOSELY: Venous thromboembolic events, including deep vein thrombosis (DVT) and pulmonary embolism (PE), have occurred during treatment with carfilzomib, and concurrent use of other agents also associated with this adverse effect can potentiate the risk. In clinical trials, the reported incidence of venous thromboembolic events was up to 15.3% with carfilzomib plus lenalidomide and dexamethasone versus 9% with lenalidomide and dexamethasone. In addition, the reported incidence of venous thromboembolic events was up to 10.6% with carfilzomib plus dexamethasone versus 3.1% with bortezomib plus dexamethasone. The incidence of thromboembolic events was 2% with carfilzomib monotherapy.

MANAGEMENT: Caution is advised when carfilzomib is used with other drugs that can increase the risk of thrombosis. Thromboprophylaxis should be considered according to local treatment protocols. Close monitoring for thromboembolic events is recommended in patients with known risk factors (e.g., prior thrombosis, hyperlipidemia, hypertension, smoking) for thromboembolism. Patients should be advised to seek immediate medical attention if they develop symptoms of thromboembolism, such as shortness of breath, chest pain, hemoptysis, or arm or leg swelling or pain.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Cerner Multum, Inc. "Australian Product Information." O 0
  3. "Product Information. Kyprolis (carfilzomib)." Onyx Pharmaceuticals Inc (2012):

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Major

bazedoxifene carfilzomib

Applies to: bazedoxifene / conjugated estrogens and carfilzomib

MONITOR CLOSELY: Venous thromboembolic events, including deep vein thrombosis (DVT) and pulmonary embolism (PE), have occurred during treatment with carfilzomib, and concurrent use of other agents also associated with this adverse effect can potentiate the risk. In clinical trials, the reported incidence of venous thromboembolic events was up to 15.3% with carfilzomib plus lenalidomide and dexamethasone versus 9% with lenalidomide and dexamethasone. In addition, the reported incidence of venous thromboembolic events was up to 10.6% with carfilzomib plus dexamethasone versus 3.1% with bortezomib plus dexamethasone. The incidence of thromboembolic events was 2% with carfilzomib monotherapy.

MANAGEMENT: Caution is advised when carfilzomib is used with other drugs that can increase the risk of thrombosis. Thromboprophylaxis should be considered according to local treatment protocols. Close monitoring for thromboembolic events is recommended in patients with known risk factors (e.g., prior thrombosis, hyperlipidemia, hypertension, smoking) for thromboembolism. Patients should be advised to seek immediate medical attention if they develop symptoms of thromboembolism, such as shortness of breath, chest pain, hemoptysis, or arm or leg swelling or pain.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Cerner Multum, Inc. "Australian Product Information." O 0
  3. "Product Information. Kyprolis (carfilzomib)." Onyx Pharmaceuticals Inc (2012):

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Drug and food interactions

Minor

conjugated estrogens food

Applies to: bazedoxifene / conjugated estrogens

Coadministration with grapefruit juice may increase the bioavailability of oral estrogens. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall induced by certain compounds present in grapefruits. In a small, randomized, crossover study, the administration of ethinyl estradiol with grapefruit juice (compared to herbal tea) increased peak plasma drug concentration (Cmax) by 37% and area under the concentration-time curve (AUC) by 28%. Based on these findings, grapefruit juice is unlikely to affect the overall safety profile of ethinyl estradiol. However, as with other drug interactions involving grapefruit juice, the pharmacokinetic alterations are subject to a high degree of interpatient variability. Also, the effect on other estrogens has not been studied.

References

  1. Weber A, Jager R, Borner A, et al. "Can grapefruit juice influence ethinyl estradiol bioavailability?" Contraception 53 (1996): 41-7
  2. Schubert W, Eriksson U, Edgar B, Cullberg G, Hedner T "Flavonoids in grapefruit juice inhibit the in vitro hepatic metabolism of 17B-estradiol." Eur J Drug Metab Pharmacokinet 20 (1995): 219-24

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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

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