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Drug Interactions between irinotecan and sorafenib

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

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Interactions between your drugs

Moderate

irinotecan SORAfenib

Applies to: irinotecan and sorafenib

MONITOR: Coadministration with sorafenib may increase the plasma concentrations of irinotecan and its pharmacologically active metabolite, SN-38. The proposed mechanism is sorafenib inhibition of CYP450 3A4 and UGT1A1, the enzymes responsible for the metabolic clearance of irinotecan and SN-38, respectively. Concomitant treatment with sorafenib has been reported to increase irinotecan systemic exposure (AUC) by 26% to 42% and SN-38 systemic exposure by 67% to 120%. The clinical significance of these changes is unknown.

MANAGEMENT: Sorafenib product labeling recommends caution during coadministration with irinotecan. High plasma levels of irinotecan and SN-38 may result in increased toxicities such as severe diarrhea, neutropenia, sepsis, and thromboembolism.

References (2)
  1. Mross K, Steinbild S, Baas F, et al. (2003) "Drug-drug interaction pharmacokinetic study with the Raf kinase inhibitor (RKI) BAY 43-9006 administered in combination with irinotecan (CPT-11) in patients with solid tumors." Int J Clin Pharmacol Ther, 41, p. 618-9
  2. (2005) "Product Information. Nexavar (sorafenib)." Bayer Pharmaceutical Inc

Drug and food interactions

Moderate

SORAfenib food

Applies to: sorafenib

ADJUST DOSING INTERVAL: Food may reduce the oral absorption and bioavailability of sorafenib. According to the product labeling, sorafenib bioavailability was reduced by 29% when administered with a high-fat meal compared to administration in the fasted state. When given with a moderate-fat meal, bioavailability was similar to that in the fasted state.

MANAGEMENT: To ensure maximal and consistent oral absorption, sorafenib should be taken at least one hour before or two hours after eating.

References (1)
  1. (2005) "Product Information. Nexavar (sorafenib)." Bayer Pharmaceutical Inc

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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