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Drug Interactions between emtricitabine / nelfinavir / tenofovir disoproxil and mobocertinib

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

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Interactions between your drugs

Major

nelfinavir mobocertinib

Applies to: emtricitabine / nelfinavir / tenofovir disoproxil and mobocertinib

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of mobocertinib, which is primarily metabolized by the isoenzyme. Elevated plasma concentrations of mobocertinib may increase the risk for adverse effects such as QT prolongation, heart failure or reduced ejection fraction, cardiomyopathy, heart block, diarrhea, rash, stomatitis, fatigue, and musculoskeletal pain. The risk of QT prolongation in particular may be increased with concomitant use of potent CYP450 3A4 inhibitors that are also known to prolong the QT interval (e.g., adagrasib, ceritinib, clarithromycin, mifepristone, saquinavir, telithromycin, some azole antifungals). Based on drug interaction studies using model-informed approaches, coadministration of mobocertinib with repeated doses of the potent CYP450 3A4 inhibitors, itraconazole or ketoconazole, is predicted to increase the steady-state combined molar AUC (systemic exposure) of mobocertinib and its active metabolites by 374% to 419%.

MANAGEMENT: Concomitant use of mobocertinib with potent CYP450 3A4 inhibitors is not recommended.

References (3)
  1. (2021) "Product Information. Exkivity (mobocertinib)." Takeda Pharmaceuticals America
  2. (2022) "Product Information. Exkivity (mobocertinib)." Takeda UK Ltd
  3. (2022) "Product Information. Exkivity (mobocertinib)." Takeda Pharmaceuticals Australia Pty Ltd, EXKIVITY PI V1.0 (CC

Drug and food interactions

Major

mobocertinib food

Applies to: mobocertinib

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of mobocertinib. The mechanism may involve inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Inhibition of hepatic CYP450 3A4 may also contribute. The interaction has not been studied with grapefruit juice. Based on drug interaction studies using model-informed approaches, coadministration of mobocertinib with multiple doses of itraconazole or ketoconazole (strong CYP450 3A4 inhibitors) is predicted to increase the steady-state combined molar AUC (systemic exposure) of mobocertinib and its active metabolites by 374% to 419%, while coadministration with multiple doses of a moderate CYP450 3A4 inhibitor is predicted to increase this value by approximately 100% to 200%. 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. Elevated plasma concentrations of mobocertinib may increase the risk for adverse effects such as QT prolongation, heart failure or reduced ejection fraction, cardiomyopathy, heart block, diarrhea, rash, stomatitis, fatigue, and musculoskeletal pain.

MANAGEMENT: Patients should avoid consumption of grapefruit and grapefruit juice during treatment with mobocertinib.

References (2)
  1. (2021) "Product Information. Exkivity (mobocertinib)." Takeda Pharmaceuticals America
  2. (2022) "Product Information. Exkivity (mobocertinib)." Takeda UK Ltd
Minor

tenofovir food

Applies to: emtricitabine / nelfinavir / tenofovir disoproxil

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

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.