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Drug Interactions between etrasimod and ProQuad

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

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Interactions between your drugs

Major

measles virus vaccine etrasimod

Applies to: ProQuad (measles virus vaccine / mumps virus vaccine / rubella virus vaccine / varicella virus vaccine) and etrasimod

Consumer information for this interaction is not currently available.

GENERALLY AVOID: The administration of live, attenuated viral or bacterial vaccines during etrasimod therapy may be associated with a risk of disseminated infection due to enhanced replication of vaccine virus or bacteria in the presence of diminished immune competence. Etrasimod causes reversible sequestration of lymphocytes in lymphoid tissues. A mean reduction in peripheral blood lymphocyte count to 45% of baseline values has been observed at 52 weeks of therapy, which may increase the risk of infections. Vaccination may also be less effective during and for up to 5 weeks after discontinuation of etrasimod therapy.

MANAGEMENT: The use of live attenuated vaccines should be avoided during and for up to 5 weeks after discontinuing etrasimod treatment. If immunization with live attenuated vaccine(s) is required, administration should occur at least 1 month prior to initiation of etrasimod. Patients without a healthcare professional-confirmed history of varicella or without documentation of a full course of vaccination against varicella-zoster virus (VZV) should be tested for antibodies to VZV before initiating treatment with etrasimod. For antibody-negative patients, a full course of vaccination with varicella vaccine is recommended prior to treatment with etrasimod. In patients who have recently been vaccinated, etrasimod therapy should be postponed for 4 weeks to allow the full effect of vaccination to occur.

References

  1. "Product Information. Velsipity (etrasimod)." Pfizer U.S. Pharmaceuticals Group (2023):
Major

rubella virus vaccine etrasimod

Applies to: ProQuad (measles virus vaccine / mumps virus vaccine / rubella virus vaccine / varicella virus vaccine) and etrasimod

Consumer information for this interaction is not currently available.

GENERALLY AVOID: The administration of live, attenuated viral or bacterial vaccines during etrasimod therapy may be associated with a risk of disseminated infection due to enhanced replication of vaccine virus or bacteria in the presence of diminished immune competence. Etrasimod causes reversible sequestration of lymphocytes in lymphoid tissues. A mean reduction in peripheral blood lymphocyte count to 45% of baseline values has been observed at 52 weeks of therapy, which may increase the risk of infections. Vaccination may also be less effective during and for up to 5 weeks after discontinuation of etrasimod therapy.

MANAGEMENT: The use of live attenuated vaccines should be avoided during and for up to 5 weeks after discontinuing etrasimod treatment. If immunization with live attenuated vaccine(s) is required, administration should occur at least 1 month prior to initiation of etrasimod. Patients without a healthcare professional-confirmed history of varicella or without documentation of a full course of vaccination against varicella-zoster virus (VZV) should be tested for antibodies to VZV before initiating treatment with etrasimod. For antibody-negative patients, a full course of vaccination with varicella vaccine is recommended prior to treatment with etrasimod. In patients who have recently been vaccinated, etrasimod therapy should be postponed for 4 weeks to allow the full effect of vaccination to occur.

References

  1. "Product Information. Velsipity (etrasimod)." Pfizer U.S. Pharmaceuticals Group (2023):
Major

mumps virus vaccine etrasimod

Applies to: ProQuad (measles virus vaccine / mumps virus vaccine / rubella virus vaccine / varicella virus vaccine) and etrasimod

Consumer information for this interaction is not currently available.

GENERALLY AVOID: The administration of live, attenuated viral or bacterial vaccines during etrasimod therapy may be associated with a risk of disseminated infection due to enhanced replication of vaccine virus or bacteria in the presence of diminished immune competence. Etrasimod causes reversible sequestration of lymphocytes in lymphoid tissues. A mean reduction in peripheral blood lymphocyte count to 45% of baseline values has been observed at 52 weeks of therapy, which may increase the risk of infections. Vaccination may also be less effective during and for up to 5 weeks after discontinuation of etrasimod therapy.

MANAGEMENT: The use of live attenuated vaccines should be avoided during and for up to 5 weeks after discontinuing etrasimod treatment. If immunization with live attenuated vaccine(s) is required, administration should occur at least 1 month prior to initiation of etrasimod. Patients without a healthcare professional-confirmed history of varicella or without documentation of a full course of vaccination against varicella-zoster virus (VZV) should be tested for antibodies to VZV before initiating treatment with etrasimod. For antibody-negative patients, a full course of vaccination with varicella vaccine is recommended prior to treatment with etrasimod. In patients who have recently been vaccinated, etrasimod therapy should be postponed for 4 weeks to allow the full effect of vaccination to occur.

References

  1. "Product Information. Velsipity (etrasimod)." Pfizer U.S. Pharmaceuticals Group (2023):
Major

varicella virus vaccine etrasimod

Applies to: ProQuad (measles virus vaccine / mumps virus vaccine / rubella virus vaccine / varicella virus vaccine) and etrasimod

Consumer information for this interaction is not currently available.

GENERALLY AVOID: The administration of live, attenuated viral or bacterial vaccines during etrasimod therapy may be associated with a risk of disseminated infection due to enhanced replication of vaccine virus or bacteria in the presence of diminished immune competence. Etrasimod causes reversible sequestration of lymphocytes in lymphoid tissues. A mean reduction in peripheral blood lymphocyte count to 45% of baseline values has been observed at 52 weeks of therapy, which may increase the risk of infections. Vaccination may also be less effective during and for up to 5 weeks after discontinuation of etrasimod therapy.

MANAGEMENT: The use of live attenuated vaccines should be avoided during and for up to 5 weeks after discontinuing etrasimod treatment. If immunization with live attenuated vaccine(s) is required, administration should occur at least 1 month prior to initiation of etrasimod. Patients without a healthcare professional-confirmed history of varicella or without documentation of a full course of vaccination against varicella-zoster virus (VZV) should be tested for antibodies to VZV before initiating treatment with etrasimod. For antibody-negative patients, a full course of vaccination with varicella vaccine is recommended prior to treatment with etrasimod. In patients who have recently been vaccinated, etrasimod therapy should be postponed for 4 weeks to allow the full effect of vaccination to occur.

References

  1. "Product Information. Velsipity (etrasimod)." Pfizer U.S. Pharmaceuticals Group (2023):

Drug and food interactions

Moderate

etrasimod food

Applies to: etrasimod

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration with moderate inhibitors of CYP450 3A4 such as grapefruit juice may increase the plasma concentrations of etrasimod in patients that are poor CYP450 2C9 metabolizers (e.g., *2/*3, *3/*3). Etrasimod is primarily metabolized by the CYP450 3A4, CYP450 2C8, and CYP450 2C9 isoenzymes. Pharmacokinetic studies reported that no single enzyme appears to dominate etrasimod elimination and that the involvement of multiple CYP450 isoforms reduces the likelihood of drug-drug interactions when only a single CYP450 isoform is strongly or moderately inhibited by a coadministered drug. In clinical drug interaction studies, when etrasimod was administered with the dual moderate CYP450 2C9 and 3A4 inhibitor fluconazole at steady-state levels, etrasimod systemic exposure (AUC) increased by 84%. However, concomitant use with the potent CYP450 3A4 inhibitor itraconazole increased the AUC of etrasimod by 32%, which was not considered by the manufacturer to be clinically significant. The effect on etrasimod systemic exposure in CYP450 2C9 intermediate metabolizers (e.g., *1/*2, *1/*3, *2/*2) treated with less potent CYP450 3A4 inhibitors is not known. Increased plasma concentrations of etrasimod may increase the risk of infection, bradyarrhythmia, AV conduction delays, elevated transaminase levels, and macular edema.

MANAGEMENT: Until further information is available, the consumption of grapefruit and grapefruit juice in combination with moderate to potent CYP450 2C8 inhibitors such as gemfibrozil should be avoided or limited during treatment with etrasimod in patients who are poor CYP450 2C9 metabolizers. Caution is recommended with grapefruit products consumption in patients who are intermediate CYP450 2C9 metabolizers. Patients should be advised to notify their physician if they experience potential adverse effects of etrasimod.

References

  1. "Product Information. Velsipity (etrasimod)." Pfizer U.S. Pharmaceuticals Group (2023):
  2. Lee C, Taylor C, Tang Y, Caballero LV, shan k, Randle A, Grundy JS "Effects of fluconazole, gemfibrozil, and rifampin on the pharmacokinetics, safety, and tolerability of etrasimod https://gut.bmj.com/content/71/Suppl_1/A142.1" (2022):

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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