Drug Interactions between daunorubicin and gadobenate dimeglumine

MONITOR: Gadobenate dimeglumine may compete with other substrates of the canalicular multispecific organic anion transporter, also known as cMOAT or MRP2, which is an endogenous transporter protein that works in coordination with the conjugation process to facilitate drug excretion. In solid tumor cells, overexpression of MRP2 confers resistance to a wide variety of anticancer chemotherapeutic agents. Substrates of MRP2 include anthracyclines, protease inhibitors, taxanes, vinca alkaloids, cisplatin, etoposide, methotrexate, and tamoxifen. Theoretically, competition for MRP2 transport may interfere with the clearance of these drugs and/or gadobenate dimeglumine. In patients with tumor cell lines that express MRP2, the interaction may also result in enhanced pharmacologic response to some chemotherapeutic agents.

MANAGEMENT: Caution is advised during concomitant use of gadobenate dimeglumine and other substrates of MRP2. Patients should be monitored for potentially increased pharmacologic effects of gadobenate dimeglumine as well as the coadministered drug(s).