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Drug Interactions between enasidenib and Viekira XR

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

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Interactions between your drugs

Moderate

ombitasvir enasidenib

Applies to: Viekira XR (dasabuvir / ombitasvir / paritaprevir / ritonavir) and enasidenib

MONITOR: Based on in vitro data, coadministration with enasidenib may increase the plasma concentrations of drugs that are substrates of the transporters, organic anion transporting polypeptides (OATP) 1B1/1B3 and breast cancer resistance protein (BCRP). The proposed mechanism is decreased clearance due to enasidenib -mediated inhibition of OATP1B1/1B3 and BCRP transporters. There are no clinical data regarding the use of enasidenib with these substrates.

MANAGEMENT: Caution is advised when enasidenib is used concurrently with medications that are substrates of OATP 1B1/1B3 and/or BCRP, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever enasidenib is added to or withdrawn from therapy.

References (2)
  1. Cerner Multum, Inc. "Australian Product Information."
  2. (2017) "Product Information. Idhifa (enasidenib)." Celgene Corporation
Moderate

paritaprevir enasidenib

Applies to: Viekira XR (dasabuvir / ombitasvir / paritaprevir / ritonavir) and enasidenib

MONITOR: Based on in vitro data, coadministration with enasidenib may increase the plasma concentrations of drugs that are substrates of the transporters, organic anion transporting polypeptides (OATP) 1B1/1B3 and breast cancer resistance protein (BCRP). The proposed mechanism is decreased clearance due to enasidenib -mediated inhibition of OATP1B1/1B3 and BCRP transporters. There are no clinical data regarding the use of enasidenib with these substrates.

MANAGEMENT: Caution is advised when enasidenib is used concurrently with medications that are substrates of OATP 1B1/1B3 and/or BCRP, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever enasidenib is added to or withdrawn from therapy.

References (2)
  1. Cerner Multum, Inc. "Australian Product Information."
  2. (2017) "Product Information. Idhifa (enasidenib)." Celgene Corporation
Moderate

dasabuvir enasidenib

Applies to: Viekira XR (dasabuvir / ombitasvir / paritaprevir / ritonavir) and enasidenib

MONITOR: Based on in vitro data, coadministration with enasidenib may increase the plasma concentrations of drugs that are substrates of the transporters, organic anion transporting polypeptides (OATP) 1B1/1B3 and breast cancer resistance protein (BCRP). The proposed mechanism is decreased clearance due to enasidenib -mediated inhibition of OATP1B1/1B3 and BCRP transporters. There are no clinical data regarding the use of enasidenib with these substrates.

MANAGEMENT: Caution is advised when enasidenib is used concurrently with medications that are substrates of OATP 1B1/1B3 and/or BCRP, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever enasidenib is added to or withdrawn from therapy.

References (2)
  1. Cerner Multum, Inc. "Australian Product Information."
  2. (2017) "Product Information. Idhifa (enasidenib)." Celgene Corporation

Drug and food interactions

Moderate

ritonavir food

Applies to: Viekira XR (dasabuvir / ombitasvir / paritaprevir / ritonavir)

ADJUST DOSING INTERVAL: Administration with food may modestly affect the bioavailability of ritonavir from the various available formulations. When the oral solution was given under nonfasting conditions, peak ritonavir concentrations decreased 23% and the extent of absorption decreased 7% relative to fasting conditions. Dilution of the oral solution (within one hour of dosing) with 240 mL of chocolate milk or a nutritional supplement (Advera or Ensure) did not significantly affect the extent and rate of ritonavir absorption. When a single 100 mg dose of the tablet was administered with a high-fat meal (907 kcal; 52% fat, 15% protein, 33% carbohydrates), approximately 20% decreases in mean peak concentration (Cmax) and systemic exposure (AUC) were observed relative to administration after fasting. Similar decreases in Cmax and AUC were reported when the tablet was administered with a moderate-fat meal. In contrast, the extent of absorption of ritonavir from the soft gelatin capsule formulation was 13% higher when administered with a meal (615 KCal; 14.5% fat, 9% protein, and 76% carbohydrate) relative to fasting.

MANAGEMENT: Ritonavir should be taken with meals to enhance gastrointestinal tolerability.

References (1)
  1. (2001) "Product Information. Norvir (ritonavir)." Abbott Pharmaceutical
Moderate

paritaprevir food

Applies to: Viekira XR (dasabuvir / ombitasvir / paritaprevir / ritonavir)

ADJUST DOSING INTERVAL: Food enhances the oral bioavailability of ombitasvir, paritaprevir, ritonavir, and dasabuvir. Relative to fasting conditions, administration of ombitasvir, paritaprevir, ritonavir, and dasabuvir with a moderate-fat meal (approximately 600 Kcal; 20% to 30% calories from fat) increased the mean systemic exposure (AUC) by 82%, 211%, 49%, and 30%, respectively. Relative to fasting conditions, administration of ombitasvir, paritaprevir, ritonavir, and dasabuvir with a high-fat meal (approximately 900 Kcal; with 60% calories from fat) increased the mean AUC by 76%, 180%, 44%, and 22%, respectively.

MANAGEMENT: Ombitasvir/paritaprevir/ritonavir plus dasabuvir should always be administered with a meal. The fat or calorie content does not matter.

References (1)
  1. (2022) "Product Information. Viekira Pak (dasabuvir/ombitasvir/paritaprev/ritonav)." AbbVie US LLC

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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