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Drug Interactions between Erleada and fostemsavir

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

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Interactions between your drugs

Major

apalutamide fostemsavir

Applies to: Erleada (apalutamide) and fostemsavir

CONTRAINDICATED: Coadministration of fostemsavir with potent CYP450 3A4 inducers may significantly decrease the plasma concentrations of temsavir, the active moiety of fostemsavir. According to the prescribing information, temsavir is a substrate of CYP450 3A4, esterases, P-glycoprotein (P-gp), and breast cancer resistance protein (BCRP). When fostemsavir (1200 mg single dose) was coadministered with the potent CYP450 3A4 inducer rifampin (600 mg once daily) in 15 study subjects, mean temsavir peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 76% and 82%, respectively, compared to fostemsavir administered alone. Induction of P-gp, an efflux transporter protein present in the apical membrane of enterocytes and kidney epithelium, may also contribute to the overall interaction.

MANAGEMENT: Given the risk of reduced viral susceptibility and resistance development associated with subtherapeutic antiretroviral drug levels, concomitant use of fostemsavir with potent CYP450 3A4 inducers is considered contraindicated.

References (3)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."
  3. (2020) "Product Information. Rukobia (fostemsavir)." ViiV Healthcare

Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

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.

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