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Drug Interactions between chloramphenicol and pralsetinib

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

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Interactions between your drugs

Moderate

chloramphenicol pralsetinib

Applies to: chloramphenicol and pralsetinib

MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of pralsetinib, which is primarily metabolized by the isoenzyme. Drug interactions studies have shown single dose administration of pralsetinib 200 mg with itraconazole, a potent CYP450 3A4 inhibitor, increased pralsetinib peak plasma concentration (Cmax) and systemic exposure (AUC) by 84% and 251%, respectively. The extent to which other, less potent CYP450 3A4 inhibitors may interact with pralsetinib is unknown. Increased exposure to pralsetinib may increase the risk and/or frequency of adverse effects such as interstitial lung disease/pneumonitis, liver transaminase elevations, hypertension, and hemorrhage.

MANAGEMENT: Caution is advised when pralsetinib is used with CYP450 3A inhibitors. Monitor closely for adverse effects whenever a CYP450 3A4 inhibitor is added to therapy. Alternative treatments may be required if an interaction is suspected.

References

  1. "Product Information. Gavreto (pralsetinib)." Blueprint Medicines Corporation (2020):

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Drug and food interactions

Major

pralsetinib food

Applies to: pralsetinib

ADJUST DOSING INTERVAL: Food significantly increases the oral bioavailability of pralsetinib. According to the product labeling, administration of pralsetinib with a high-fat meal (approximately 800 to 1000 calories; 50% to 60% from fat) increased mean pralsetinib peak plasma concentration (Cmax) and systemic exposure (AUC) by 104% and 122%, respectively. The median time to maximum concentration (Tmax) was delayed from 4 to 8.5 hours.

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of pralsetinib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition. Increased exposure to pralsetinib may increase the risk of adverse effects such as musculoskeletal toxicity, fatigue, constipation, hypertension, and pneumonia.

MANAGEMENT: Pralsetinib should be administered on an empty stomach, at least 2 hours after or 1 hour before a meal. Patients should avoid consumption of grapefruit or grapefruit juice during treatment with pralsetinib.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. "Product Information. Gavreto (pralsetinib)." Blueprint Medicines Corporation (2020):
  3. "Product Information. Gavreto (pralsetinib)." Roche Products Pty Ltd GAVRETO 20230406 (2023):

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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.

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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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