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Drug Interactions between deflazacort and idecabtagene vicleucel

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

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Interactions between your drugs

Major

deflazacort idecabtagene vicleucel

Applies to: deflazacort and idecabtagene vicleucel

GENERALLY AVOID: Prophylactic use of systemic corticosteroids prior to CD19- or BCMA-directed genetically modified autologous T cell immunotherapy may interfere with the therapeutic effects of such drugs as axicabtagene ciloleucel, brexucabtagene autoleucel, idecabtagene vicleucel, ciltacabtagene autoleucel and lisocabtagene maraleucel. The mechanism for this interaction has not been delineated. Administration of systemic corticosteroids in an effort to manage the toxicities associated with these drugs does not affect the expansion and persistence of CAR T cells.

MANAGEMENT: The prophylactic use of systemic corticosteroids prior to CD19- or BCMA-directed genetically modified autologous T cell immunotherapy with drugs such as axicabtagene ciloleucel, brexucabtagene autoleucel, idecabtagene vicleucel, ciltacabtagene autoleucel and lisocabtagene maraleucel is not recommended. However, systemic corticosteroids may be used for the management of adverse effects associated with these drugs, such as cytokine release syndrome and neurological-related toxicities, without affecting the expansion and persistence of CAR T cells.

References (5)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. (2017) "Product Information. Yescarta (axicabtagene ciloleucel)." Kite Pharma, Inc.
  3. (2020) "Product Information. Tecartus (brexucabtagene autoleucel)." Kite Pharma, Inc.
  4. (2021) "Product Information. Breyanzi (lisocabtagene maraleucel)." Bristol-Myers Squibb
  5. (2021) "Product Information. Abecma (idecabtagene vicleucel)." Celgene Corporation

Drug and food interactions

Moderate

deflazacort food

Applies to: deflazacort

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of 21-desdeflazacort, the active metabolite of deflazacort that is formed by esterases after oral administration and further metabolized by CYP450 3A4 to several inactive metabolites. The proposed mechanism is inhibition of CYP450 3A4-mediated 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 systemic exposure to 21-desdeflazacort may increase the risk of corticosteroid adverse effects such as hypercorticism, hyperglycemia, adrenal suppression, immunosuppression, hypertension, salt and water retention, electrolyte abnormalities, behavioral and mood disturbances, posterior subcapsular cataracts, glaucoma, bone loss, and growth retardation in children and adolescents.

MANAGEMENT: Deflazacort should not be administered with grapefruit juice.

References (1)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."

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

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