Drug Interactions between crizotinib and Enlon

GENERALLY AVOID: Crizotinib can cause bradycardia and may have additive effects with other drugs that also slow the heart rate. Bradycardia with a heart rate less than 50 beats per minute occurred in 10% to 14% of patients treated with crizotinib in two clinical studies.

MANAGEMENT: Concomitant use of crizotinib with other agents known to cause bradycardia such as beta-blockers, calcium channel blockers, cholinesterase inhibitors, clonidine, and digoxin should generally be avoided whenever possible. Otherwise, heart rate and blood pressure should be monitored closely. If Grade 2 or 3 symptomatic bradycardia occurs, crizotinib should be withheld, the use of concomitant medications re-evaluated, and the dosage of crizotinib adjusted accordingly. Crizotinib should be permanently discontinued for Grade 4 bradycardia. In patients who develop Grade 4 bradycardia associated with concomitant medications known to cause bradycardia or hypotension, crizotinib should be withheld until Grade 1 or less, and if concomitant medications can be discontinued, crizotinib may be restarted at 250 mg once daily with frequent monitoring.