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Drug Interactions between cabozantinib and treosulfan

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

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Interactions between your drugs

Moderate

treosulfan cabozantinib

Applies to: treosulfan and cabozantinib

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with treosulfan may increase the plasma concentrations of drugs that are substrates of CYP450 3A4, 2C19, and/or the efflux transporter P-glycoprotein (P-gp). The proposed mechanism is decreased clearance due to inhibition of these routes of elimination due to treosulfan. According to physiologically-based pharmacokinetic modeling, treosulfan is predicted to be a weak to moderate CYP450 3A4 inhibitor and weak inhibitor of CYP450 2C19, with negligible inhibitory effects on P-gp. However, according to the manufacturer, in vitro studies were unable to exclude potential drug-drug interactions with high plasma concentrations of treosulfan and CYP450 3A4, 2C19, and/or P-gp substrates.

MANAGEMENT: Caution is recommended if treosulfan is coadministered with substrates of CYP450 3A4, 2C19, and/or P-gp, particularly those with a narrow therapeutic range. Some authorities advise that if concomitant use is required, the dosage of these substrates should be administered either 2 hours before or 8 hours after administration of the treosulfan infusion. The prescribing information of the substrates may be consulted for potential dose reductions.

Drug and food interactions

Moderate

cabozantinib food

Applies to: cabozantinib

Cabozantinib should be taken on an empty stomach, one hour before or two hours after a meal. Do not consume grapefruit, grapefruit juice, or any supplements that contain grapefruit extract during treatment with cabozantinib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of cabozantinib. You may be more likely to experience side effects such as nausea; vomiting; diarrhea; loss of appetite; weight loss; mouth sores; abdominal pain; skin rash (primarily on the palms of the hands and soles of the feet); delayed wound healing; high blood pressure; and impaired bone marrow function resulting in low numbers of different types of blood cells, which can increase the risk of bleeding problems and infections. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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