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Drug Interactions between doravirine / lamivudine / tenofovir and tucatinib

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

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Interactions between your drugs

Moderate

tenofovir tucatinib

Applies to: doravirine / lamivudine / tenofovir and tucatinib

MONITOR: Coadministration with tucatinib may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) transporter. The mechanism likely involves tucatinib-mediated inhibition of P-gp. When a single 0.5 mg dose of digoxin, a P-gp substrate, was administered with tucatinib (300 mg twice daily), digoxin peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 2.4-fold and 1.5-fold, respectively. Increased exposure to the P-gp substrate may increase the risk of toxicity.

MANAGEMENT: Caution is advised if tucatinib is used concomitantly with P-gp substrates, particularly those with a narrow therapeutic index. A dose reduction of the P-gp substrates as well as clinical and laboratory monitoring may be appropriate.

References

  1. (2020) "Product Information. Tukysa (tucatinib)." Seattle Genetics Inc

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Moderate

doravirine tucatinib

Applies to: doravirine / lamivudine / tenofovir and tucatinib

MONITOR: Coadministration with CYP450 3A4 inducers may decrease the plasma concentrations of tucatinib, which is primarily metabolized by CYP450 2C8 and to a lesser extent by CYP450 3A4. When rifampin (600 mg once daily), a potent CYP450 3A4 and moderate CYP450 2C8 inducer, was administered with a single tucatinib dose of 300 mg, tucatinib peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 40% and 50%, respectively. No data are available for other, less potent CYP450 3A4 inducers.

MANAGEMENT: The potential for diminished pharmacologic effects of tucatinib should be considered during coadministration with CYP450 3A4 inducers. Alternative treatments may be required if an interaction is suspected.

References

  1. (2020) "Product Information. Tukysa (tucatinib)." Seattle Genetics Inc

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Drug and food interactions

Minor

tenofovir food

Applies to: doravirine / lamivudine / tenofovir

Food enhances the oral absorption and bioavailability of tenofovir, the active entity of tenofovir disoproxil fumarate. According to the product labeling, administration of the drug following a high-fat meal increased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of tenofovir by approximately 14% and 40%, respectively, compared to administration in the fasting state. However, administration with a light meal did not significantly affect the pharmacokinetics of tenofovir compared to administration in the fasting state. Food delays the time to reach tenofovir Cmax by approximately 1 hour. Tenofovir disoproxil fumarate may be administered without regard to meals.

References

  1. (2001) "Product Information. Viread (tenofovir)." Gilead Sciences

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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.