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Drug Interactions between enfortumab vedotin and tecovirimat

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

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Interactions between your drugs

Minor

enfortumab vedotin tecovirimat

Applies to: enfortumab vedotin and tecovirimat

Coadministration with inducers of CYP450 3A4 or dual P-glycoprotein (P-gp) and CYP450 3A4 inducers may decrease the plasma concentrations and effects of unconjugated monomethyl auristatin E (MMAE), the cytotoxic component of enfortumab vedotin. Enfortumab vedotin is an antibody-drug conjugate (ADC) that releases MMAE, via proteolytic cleavage. MMAE has been shown in vitro to be primarily metabolized by CYP450 3A4 as well as being a substrate of P-gp. According to physiologically-based pharmacokinetic (PBPK) modeling, concomitant use of enfortumab vedotin with rifampin, a dual P-gp and strong CYP450 3A4 inducer, is predicted to decrease unconjugated MMAE peak plasma concentration (Cmax) by 28% and systemic exposure (AUC) by 53%, with no change in ADC exposure. Some authorities suggest that the PBPK model may underestimate the full impact of rifampin on the Cmax of MMAE. The clinical significance of the interaction is unclear, since the intact ADC is required to bind to Nectin-4, an adhesion protein found on the surface of cells, which allows for internalization and cleavage by lysosomal proteases to enable intracellular delivery of MMAE. It is not known if, and to what extent, enfortumab vedotin may interact with less potent CYP450 3A4 inducers.

References (5)
  1. (2023) "Product Information. Padcev (enfortumab vedotin)." Astellas Pharma Australia Pty Ltd
  2. (2023) "Product Information. Padcev (enfortumab vedotin)." Seagen Inc
  3. (2021) "Product Information. Padcev (enfortumab vedotin)." Seagen Canada Inc
  4. (2022) "Product Information. Padcev (enfortumab vedotine)." ASTELLAS PHARMA
  5. (2022) "Product Information. Padcev (enfortumab vedotin)." Astellas Pharma Ltd

Drug and food interactions

Moderate

tecovirimat food

Applies to: tecovirimat

ADJUST DOSING INTERVAL: Food may increase the extent of tecovirimat absorption following oral administration. When the recommended oral dose of tecovirimat (600 mg every 12 hours) was administered with a meal (approximately 600 calories and 25 g of fat) in healthy adults weighing less than 120 kg, tecovirimat absorption increased by 39% relative to fasting.

MANAGEMENT: Oral tecovirimat should be taken within 30 minutes after a full meal containing moderate or high fat (approximately 600 calories and 25 g of fat) with 6 to 8 ounces of water.

References (1)
  1. "Product Information. Tpoxx (tecovirimat)." SIGA Technologies, 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.


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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.