Drug Interactions between Inrebic and Xolremdi
This report displays the potential drug interactions for the following 2 drugs:
- Inrebic (fedratinib)
- Xolremdi (mavorixafor)
Interactions between your drugs
fedratinib mavorixafor
Applies to: Inrebic (fedratinib) and Xolremdi (mavorixafor)
Consumer information for this interaction is not currently available.
MONITOR CLOSELY: Coadministration with P-glycoprotein (P-gp) and/or moderate CYP450 3A4 inhibitors may increase the plasma concentrations and effects of mavorixafor, which is both a substrate of the P-gp efflux transporter and primarily metabolized by CYP450 3A4. When a single dose of mavorixafor (200 mg) was coadministered with the strong CYP450 3A4 and P-gp inhibitor itraconazole (200 mg at steady state), mavorixafor's systemic exposure (AUC) increased approximately 2-fold. The resulting AUC was similar to that expected from a single dose of 400 mg given alone to healthy subjects. Clinical data with drugs that are less potent inhibitors or only inhibit CYP450 3A4 or P-gp are not available. As mavorixafor causes concentration-dependent QT interval prolongation, an increase in its AUC could increase the possibility of experiencing this adverse effect. Likewise, this risk may be further increased if the P-gp and/or CYP450 3A4 inhibitor being used also carries a risk of QT prolongation (e.g., amiodarone, azithromycin, bepridil, ciprofloxacin, clofazimine, crizotinib, dronedarone, erythromycin, fluconazole, lapatinib, oral lefamulin, nilotinib, osimertinib, pacritinib, quinidine, quinine, ranolazine, ribociclib).
MANAGEMENT: Caution and close clinical monitoring for adverse effects associated with mavorixafor, such as QT prolongation, are advised if concurrent use with a P-gp and/or moderate CYP450 3A4 inhibitor is required. Any modifiable risk factors for QT prolongation, such as electrolyte abnormalities, should be corrected. The QTc (QT interval corrected for heart rate) should be assessed at baseline and as clinically indicated during concomitant therapy. If adverse reactions associated with mavorixafor develop, its daily dose should be reduced by steps of 100 mg, as described in the labeling, but not to a dose less than 200 mg. If the P-gp and/or CYP450 3A4 inhibitor also carries a risk of QTc prolongation, its labeling should be consulted as well for more specific guidance on monitoring and potential adjustments to treatment should this adverse effect occur.
Drug and food interactions
mavorixafor food
Applies to: Xolremdi (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.
fedratinib food
Applies to: Inrebic (fedratinib)
Grapefruit juice can increase the blood levels of fedratinib. This may increase the risk of serious side effects such as Wernicke's encephalopathy, a potentially fatal condition of the brain associated with thiamine (vitamin B1) deficiency; low blood cell counts, which can lead to anemia, bleeding, and infections; severe diarrhea, nausea, and vomiting; problems in the liver or pancreas; and development of other cancers. You should avoid the consumption of grapefruit and grapefruit juice during treatment with fedratinib. You may take the medication with or without food, but taking it with a high-fat meal may help reduce nausea and vomiting. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. 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.
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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