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Drug Interactions between cabazitaxel and ivacaftor / tezacaftor

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

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Interactions between your drugs

Moderate

cabazitaxel ivacaftor

Applies to: cabazitaxel and ivacaftor / tezacaftor

MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of cabazitaxel, which is primarily metabolized by the isoenzyme. However, no formal drug interaction studies have been conducted.

MANAGEMENT: Caution is advised if cabazitaxel is prescribed with CYP450 3A4 inhibitors. Pharmacologic response to cabazitaxel should be monitored more closely whenever a CYP450 3A4 inhibitor is added to or withdrawn from therapy, and the cabazitaxel dosage adjusted as necessary. Regular monitoring of peripheral blood counts between treatment cycles is recommended, and patients should be advised to contact their physician if they experience potential signs and symptoms of cabazitaxel toxicity such as infection, fever, chills, diarrhea, unusual bruising or bleeding, and burning, tingling, or numbness in the hands and feet.

References

  1. "Product Information. Jevtana (cabazitaxel)." sanofi-aventis (2010):

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Drug and food interactions

Moderate

ivacaftor food

Applies to: ivacaftor / tezacaftor

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of ivacaftor. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Elexacaftor and tezacaftor are also CYP450 3A4 substrates in vitro and may interact similarly with grapefruit juice, whereas lumacaftor is not expected to interact.

ADJUST DOSING INTERVAL: According to prescribing information, systemic exposure to ivacaftor increased approximately 2.5- to 4-fold, systemic exposure to elexacaftor increased approximately 1.9- to 2.5-fold, and systemic exposure to lumacaftor increased approximately 2-fold following administration with fat-containing foods relative to administration in a fasting state. Tezacaftor exposure is not significantly affected by administration of fat-containing foods.

MANAGEMENT: Patients treated with ivacaftor-containing medications should avoid consumption of grapefruit juice and any food that contains grapefruit or Seville oranges. All ivacaftor-containing medications should be administered with fat-containing foods such as eggs, avocados, nuts, meat, butter, peanut butter, cheese pizza, and whole-milk dairy products. A typical cystic fibrosis diet will satisfy this requirement.

References

  1. "Product Information. Kalydeco (ivacaftor)." Vertex Pharmaceuticals (2012):
  2. "Product Information. Orkambi (ivacaftor-lumacaftor)." Vertex Pharmaceuticals (2015):
  3. "Product Information. Symdeko (ivacaftor-tezacaftor)." Vertex Pharmaceuticals (2022):
  4. "Product Information. Trikafta (elexacaftor/ivacaftor/tezacaftor)." Vertex Pharmaceuticals (2019):
View all 4 references

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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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