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Drug Interactions between emtricitabine / nelfinavir / tenofovir and Lynparza

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

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Interactions between your drugs

Major

nelfinavir olaparib

Applies to: emtricitabine / nelfinavir / tenofovir and Lynparza (olaparib)

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of olaparib, which is primarily metabolized by the isoenzyme. In a drug interaction study with 57 patients, olaparib peak plasma concentration (Cmax) and systemic exposure (AUC) increased by approximately 1.4- and 2.7-fold, respectively, during coadministration with the potent CYP450 3A4 inhibitor itraconazole. Increased exposure to olaparib may increase the risk of adverse effects such as hematologic toxicity, nausea, vomiting, diarrhea, anorexia, dyspepsia, and abdominal pain or discomfort.

MANAGEMENT: Concomitant use of olaparib with potent CYP450 3A4 inhibitors should be avoided whenever possible. Some authorities recommend avoiding concomitant use of olaparib during and for 2 weeks after treatment with itraconazole. If coadministration is required, dose reductions are recommended as follows: the olaparib tablet dosage should be reduced to 100 mg twice a day; the olaparib capsule dosage should be reduced to 150 mg twice a day. Specific dose recommendations for each formulation should be followed as the tablet and capsule formulations are not interchangeable due to differences in bioavailability. Once the CYP450 3A4 inhibitor has been discontinued for 3 to 5 elimination half-lives, the usual olaparib dose should be resumed.

References

  1. "Product Information. Sporanox (itraconazole)." Janssen Pharmaceuticals PROD (2002):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. Cerner Multum, Inc. "Australian Product Information." O 0
  4. "Product Information. Lynparza (olaparib)." Astra-Zeneca Pharmaceuticals (2014):
View all 4 references

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Drug and food interactions

Major

olaparib food

Applies to: Lynparza (olaparib)

GENERALLY AVOID: Grapefruit juice may significantly increase the plasma concentrations of olaparib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. In a drug interaction study with 57 patients, olaparib systemic exposure (AUC) was increased approximately 2.7-fold by the potent CYP450 3A4 inhibitor itraconazole. Simulations using physiologically-based pharmacokinetic (PBPK) models suggest that a moderate inhibitor (fluconazole) may increase the AUC of olaparib by 2-fold. The interaction has not been studied with grapefruit juice. 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 exposure to olaparib may increase the risk of adverse effects such as hematologic toxicity, nausea, vomiting, diarrhea, anorexia, dyspepsia, and abdominal pain or discomfort.

MANAGEMENT: Patients treated with olaparib should avoid consumption of grapefruit, grapefruit juice, starfruit (carambola), and Seville oranges.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Cerner Multum, Inc. "Australian Product Information." O 0
  3. "Product Information. Lynparza (olaparib)." Astra-Zeneca Pharmaceuticals (2014):

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Minor

tenofovir food

Applies to: emtricitabine / nelfinavir / 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. "Product Information. Viread (tenofovir)." Gilead Sciences (2001):

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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.

See also

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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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