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Drug Interactions between epcoritamab and Inspra

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

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Interactions between your drugs

Moderate

eplerenone epcoritamab

Applies to: Inspra (eplerenone) and epcoritamab

MONITOR: Coadministration with epcoritamab may increase the plasma concentrations of drugs that are substrates of CYP450 isoenzymes. Initiation of epcoritamab treatment causes transient release of cytokines that may suppress CYP450 isoenzymes, although the potential for an interaction has not been studied. According to the manufacturer, the highest drug-drug interaction risk would be from the first dose on the first day of cycle 1, up to 14 days after the first 48 mg dose on day 15 of cycle 1, as well as during and after cytokine release syndrome.

MANAGEMENT: Caution is advised when epcoritamab is administered with drugs that are metabolized by CYP450 isoenzymes, particularly those with a narrow therapeutic range, where minimal changes to concentration may lead to significant adverse reactions, such as carbamazepine, colchicine, cyclosporine, disopyramide, phenytoin, quinidine, theophylline, warfarin, macrolide immunosuppressants, vinca alkaloids, and some narcotic analgesics. Clinical and/or laboratory monitoring are recommended, particularly at the initial phase of treatment with epcoritamab as well as during and after cytokine release syndrome, and the dosage(s) of the CYP450 substrate(s) adjusted accordingly.

References (3)
  1. (2023) "Product Information. Epkinly (epcoritamab)." Genmab US, Inc.
  2. (2025) "Product Information. Epkinly (epcoritamab)." AbbVie Pty Ltd, EPKINLY PI v 2 CCDS
  3. Sychev DA, Ashraf DM, Svistunov AA (2018) "The cytochrome P450 isoenzyme and some new opportunities for the prediction of negative drug interaction in vivo" Dovepress Taylor & Francis Group, 12, p. 1147-56

Drug and food/lifestyle interactions

Moderate

eplerenone food/lifestyle

Applies to: Inspra (eplerenone)

GENERALLY AVOID: Coadministration with grapefruit juice may increase the plasma concentrations of eplerenone. The primary mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. Inhibition of hepatic CYP450 3A4 may also contribute. In drug interaction studies, administration of a single 100 mg dose of eplerenone in combination with grapefruit juice resulted in a 25% increase in eplerenone systemic exposure (AUC). High blood levels of eplerenone can increase the risk of side effects including hyperkalemia. 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.

MANAGEMENT: It may be advisable for patients to avoid the consumption of grapefruit, grapefruit juice, or supplements that contain grapefruit during treatment with eplerenone.

References (5)
  1. (2023) "Product Information. Eplerenone (Apotex) (eplerenone)." Apotex Pty Ltd
  2. (2023) "Product Information. Inspra (eplerenone)." Viatris Specialty LLC
  3. (2023) "Product Information. Jamp Eplerenone (eplerenone)." Jamp Pharma Corporation
  4. (2023) "Product Information. Inpler (eplerenone)." Generic Partners Pty Ltd
  5. (2023) "Product Information. Eplerenone (eplerenone)." Amarox Ltd

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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