Drug Interactions between Ingrezza and mavorixafor
This report displays the potential drug interactions for the following 2 drugs:
- Ingrezza (valbenazine)
- mavorixafor
Interactions between your drugs
valbenazine mavorixafor
Applies to: Ingrezza (valbenazine) and mavorixafor
Consumer information for this interaction is not currently available.
CONTRAINDICATED: Administration of mavorixafor with substrates of CYP450 2D6 is expected to significantly increase the plasma concentrations and effects of the substrate. The mechanism is decreased clearance due to inhibition of CYP450 2D6 by mavorixafor. Conversely, if the substrate is a prodrug, then mavorixafor would be expected to reduce the plasma concentrations of the active drug and thus its efficacy by inhibiting the prodrug's conversion to an active metabolite(s) via CYP450 2D6. When mavorixafor (400 mg) was used concurrently with the sensitive CYP450 2D6 substrate dextromethorphan in healthy subjects, dextromethorphan's peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 6-fold and 9-fold, respectively. Clinical data are not available with every CYP450 2D6 substrate.
MANAGEMENT: The manufacturer of mavorixafor considers coadministration with drugs that are highly dependent on CYP450 2D6 for clearance to be contraindicated. Likewise, due to the potential for a significant reduction in efficacy, prodrugs which are highly dependent on conversion via CYP450 2D6 for efficacy, like codeine, should also be avoided in combination with mavorixafor.
Drug and food interactions
valbenazine food
Applies to: Ingrezza (valbenazine)
Grapefruit and grapefruit juice may increase the blood levels and effects of valbenazine, such as drowsiness and an irregular heart rhythm problem called QT prolongation. Irregular heart rhythm problems may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have questions or concerns. Do not add grapefruit products to your diet, or increase or decrease the amount currently in your diet without first talking to your doctor. You may need a dose adjustment of valbenazine or more frequent monitoring by your doctor to safely use both valbenazine and grapefruit products. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
mavorixafor food
Applies to: mavorixafor
Consumer information for this interaction is not currently available.
GENERALLY AVOID: Grapefruit products may significantly increase the plasma concentrations and effects of mavorixafor, which is primarily metabolized by the isoenzyme CYP450 3A4. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. A study examining mavorixafor in combination with the strong CYP450 3A4 and P-glycoprotein inhibitor, itraconazole, suggests an increase in mavorixafor's systemic exposure (AUC) of approximately 2-fold. Clinical data with grapefruit products are not available. Pharmacokinetic interactions involving grapefruit are subject to a high degree of interpatient variability and can also be affected by the product and amount consumed; therefore, the extent to which a given patient may be affected is difficult to predict. Additionally, since mavorixafor is associated with concentration-dependent prolongation of the QT interval, increased levels may potentiate the risk of ventricular arrhythmias such as torsade de pointes and sudden death.
ADJUST DOSING INTERVAL: Food may significantly reduce the peak plasma concentration (Cmax) and systemic exposure (AUC) of mavorixafor. When a single-dose of mavorixafor (400 mg) was administered with a high-fat meal (1000 calories, 50% fat) to healthy subjects, the Cmax and AUC decreased by 66% and 55%, respectively. Similarly, when the same dose was given with a low-fat meal (500 calories, 25% fat) to healthy subjects, mavorixafor's Cmax and AUC decreased by 55% and 51%, respectively. Additionally, a single dose of mavorixafor (400 mg) administered with a low-fat meal to healthy subjects following an overnight fast resulted in a 14% higher Cmax and an 18% lower AUC than those obtained from subjects who fasted for an additional 4 hours after the dose.
MANAGEMENT: Mavorixafor should be taken on an empty stomach after an overnight fast, 30 minutes before food. Patients should be advised to avoid eating or drinking products containing grapefruit, as this could increase the risk of experiencing adverse effects from mavorixafor such as QT prolongation.
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
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
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