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Drug Interactions between eltrombopag and Kyprolis

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

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Interactions between your drugs

Major

eltrombopag carfilzomib

Applies to: eltrombopag and Kyprolis (carfilzomib)

MONITOR CLOSELY: Venous thromboembolic events, including deep vein thrombosis (DVT) and pulmonary embolism (PE), have occurred during treatment with carfilzomib, and concurrent use of other agents also associated with this adverse effect can potentiate the risk. In clinical trials, the reported incidence of venous thromboembolic events was up to 15.3% with carfilzomib plus lenalidomide and dexamethasone versus 9% with lenalidomide and dexamethasone. In addition, the reported incidence of venous thromboembolic events was up to 10.6% with carfilzomib plus dexamethasone versus 3.1% with bortezomib plus dexamethasone. The incidence of thromboembolic events was 2% with carfilzomib monotherapy.

MANAGEMENT: Caution is advised when carfilzomib is used with other drugs that can increase the risk of thrombosis. Thromboprophylaxis should be considered according to local treatment protocols. Close monitoring for thromboembolic events is recommended in patients with known risk factors (e.g., prior thrombosis, hyperlipidemia, hypertension, smoking) for thromboembolism. Patients should be advised to seek immediate medical attention if they develop symptoms of thromboembolism, such as shortness of breath, chest pain, hemoptysis, or arm or leg swelling or pain.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."
  3. (2012) "Product Information. Kyprolis (carfilzomib)." Onyx Pharmaceuticals Inc

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Drug and food interactions

Moderate

eltrombopag food

Applies to: eltrombopag

ADJUST DOSING INTERVAL: Food may reduce the oral bioavailability of eltrombopag. In healthy volunteers, a standard high-fat breakfast significantly decreased plasma eltrombopag peak plasma concentration (Cmax) by 65% and systemic exposure (AUC) by 59% and delayed Tmax by one hour. The calcium content of this meal may have also contributed to this decrease in exposure. In another study, adult subjects administered a single 25 mg dose of eltrombopag for oral suspension with a high-calcium, moderate-fat, moderate-calorie meal exhibited a 79% decrease in Cmax and 75% decrease in AUC of eltrombopag. Administration of eltrombopag 2 hours after the high-calcium meal decreased eltrombopag Cmax by 48% and AUC by 47%, while administration 2 hours before the high-calcium meal decreased eltrombopag Cmax by 14% and AUC by 20%.

ADJUST DOSING INTERVAL: Polyvalent cations such as aluminum, calcium, iron, magnesium, and zinc can significantly reduce the gastrointestinal absorption of eltrombopag due to chelation. In one clinical trial, administration of a single 75 mg dose of eltrombopag with an antacid containing 1524 mg aluminum hydroxide and 1425 mg magnesium carbonate resulted in an approximately 70% decrease in eltrombopag Cmax and AUC.

MANAGEMENT: Eltrombopag should be taken on an empty stomach one hour before or two hours after a meal. Additionally, eltrombopag should be taken at least 2 hours before or 4 hours after any products that contain polyvalent cations such as antacids, mineral supplements, dairy products, and fortified juices.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. (2008) "Product Information. Promacta (eltrombopag)." GlaxoSmithKline

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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.

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