Drug Interactions between eliglustat and pexidartinib
This report displays the potential drug interactions for the following 2 drugs:
- eliglustat
- pexidartinib
Interactions between your drugs
eliglustat pexidartinib
Applies to: eliglustat and pexidartinib
MONITOR: Coadministration with inducers of CYP450 3A4 and/or P-glycoprotein (P-gp) may decrease the plasma concentrations of eliglustat, which is primarily metabolized by CYP450 2D6 and, to a lesser extent, CYP450 3A4. Eliglustat is also a substrate of P-gp efflux transporter. In pharmacokinetic studies, treatment with the potent CYP450 3A4/P-gp inducer rifampin (600 mg once daily) decreased eliglustat peak plasma concentration (Cmax) and systemic exposure (AUC) by approximately 90% in CYP450 2D6 extensive and intermediate metabolizers administered eliglustat 127 mg twice daily, and 95% in poor metabolizers administered eliglustat 84 mg twice daily. No data are available for use with other, less potent inducers.
MANAGEMENT: Patients receiving eliglustat with CYP450 3A4 inducers should be monitored for potentially diminished pharmacologic response to eliglustat. Concomitant use should be avoided if an interaction is suspected.
References (1)
- (2014) "Product Information. Cerdelga (eliglustat)." Genzyme Corporation
Drug and food interactions
eliglustat food
Applies to: eliglustat
GENERALLY AVOID: Grapefruit juice may significantly increase the systemic exposure to eliglustat. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Because eliglustat is predicted to cause prolongation of the PR, QTc, and QRS cardiac intervals at substantially elevated plasma concentrations, consumption of grapefruit juice during treatment may increase the risk of bradycardia, atrioventricular block, cardiac arrest, and serious ventricular arrhythmias such as torsade de pointes.
MANAGEMENT: Patients treated with eliglustat should avoid consumption of grapefruit and grapefruit juice.
References (1)
- (2014) "Product Information. Cerdelga (eliglustat)." Genzyme Corporation
pexidartinib food
Applies to: pexidartinib
ADJUST DOSING INTERVAL: The presence of food may increase the absorption and toxicity of pexidartinib. Administration of pexidartinib with a high-fat meal increased peak plasma concentration (Cmax) and systemic exposure (AUC) by 100% and prolonged the time to reach peak plasma concentration (Tmax) by 2.5 hours.
GENERALLY AVOID: Grapefruit or grapefruit juice may increase the plasma concentration and risk of adverse effects of pexidartinib, including potentially fatal hepatotoxicity. The mechanism is inhibition of CYP450 3A4-mediated metabolism of pexidartinib by certain compounds present in grapefruits. Concomitant administration of itraconazole, a strong CYP450 3A4 inhibitor, increased pexidartinib peak plasma concentration (Cmax) and systemic exposure (AUC) by 48% and 70%, respectively.
MANAGEMENT: Pexidartinib should be administered on an empty stomach, at least one hour before or two hours after a meal or snack. Consumption of grapefruit or grapefruit juice should generally be avoided during pexidartinib therapy. If concomitant use is unavoidable, the dose of pexidartinib should be reduced according to the manufacturer's recommendations. If concomitant use of grapefruit or grapefruit juice is discontinued, the dose of pexidartinib may be increased (after 3 plasma half-lives of a strong CYP450 3A4 inhibitor) to the dose that was used prior to consumption of grapefruit or grapefruit juice.
References (1)
- (2019) "Product Information. Turalio (pexidartinib)." Daiichi Sankyo, Inc.
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.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
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