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Drug Interactions between fluvoxamine and ixabepilone

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

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Interactions between your drugs

Moderate

fluvoxaMINE ixabepilone

Applies to: fluvoxamine and ixabepilone

MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of ixabepilone, which is primarily metabolized by the isoenzyme. According to the product labeling, administration of ixabepilone in combination with the potent inhibitor ketoconazole resulted in a 79% increase in ixabepilone systemic exposure (AUC) compared to treatment without ketoconazole. The effect of mild or moderate inhibitors such as erythromycin, fluconazole, or verapamil on exposure to ixabepilone has not been studied.

MANAGEMENT: Caution is advised when ixabepilone is prescribed with CYP450 3A4 inhibitors. Pharmacologic response to ixabepilone should be monitored more closely whenever a CYP450 3A4 inhibitor is added to or withdrawn from therapy, and the ixabepilone dosage adjusted as necessary. Frequent monitoring of peripheral blood counts between treatment cycles is recommended, and patients should be advised to contact their physician if they experience signs and symptoms of ixabepilone toxicities such as infection or burning, tingling, or numbness in the hands and feet.

References

  1. (2007) "Product Information. Ixempra (ixabepilone)." Bristol-Myers Squibb

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Drug and food interactions

Moderate

fluvoxaMINE food

Applies to: fluvoxamine

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
View all 4 references

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Moderate

ixabepilone food

Applies to: ixabepilone

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of ixabepilone. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits.

MANAGEMENT: Patients treated with ixabepilone should avoid the consumption of grapefruit or grapefruit juice.

References

  1. (2007) "Product Information. Ixempra (ixabepilone)." Bristol-Myers Squibb

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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.