Drug Interactions between capivasertib and Cycloset

Consumer information for this interaction is not currently available.

MONITOR CLOSELY: Capivasertib may interfere with the therapeutic effects of insulin and/or antidiabetic agents. Fluctuations in blood glucose levels may be related to capivasertib-mediated inhibition of the serine/threonine kinase (AKT) pathway, a critical regulator of glucose metabolism. Hypoglycemia and hyperglycemia, including diabetic ketoacidosis (DKA) and fatal outcomes, have been reported and may occur at any point during treatment. However, the median time to the first occurrence of hyperglycemia was reported at 15 days after starting capivasertib. In addition, in some cases, DKA was observed within 10 days after commencing capivasertib. In the phase 3 randomized, double-blind, placebo-controlled trial, CAPItello-291, 12% of patients who received capivasertib had an anti-hyperglycemic medication regimen either initiated or modified during the study, including treatment with insulin in 4.8% of patients. However, clinical data are lacking in patients with Type 1 diabetes, Type 2 diabetes requiring insulin or those with a glycated hemoglobin (HbA1c) of 8%, as they were excluded from the CAPItello-291 trial.

MANAGEMENT: Glycemic status, including fasting plasma glucose and/or HbA1c, should be assessed prior to the initiation of capivasertib therapy and closely monitored during and after discontinuation of therapy, especially in those receiving insulin or other antidiabetic agents. Patients should learn to recognize the symptoms of hypoglycemia such as headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, palpitation, and tachycardia. If hypo-or hyperglycemia occurs during capivasertib therapy, patients should be initiated on appropriate remedial therapy immediately. The manufacturer's product labeling should also be consulted for specific management and dosage adjustment guidance.