Interactions between Lazertinib and Protostat
1 drug interaction and 18 additional warnings found for the following 2 drugs:
- lazertinib
- Protostat (metronidazole)
Drug interactions
Moderate drug interactions
Moderate:
metroNIDAZOLE lazertinib
Applies to: Protostat (metronidazole) and lazertinib
Monitor
The risk of peripheral neuropathy may be increased during concurrent use of two or more agents that are associated with this adverse effect. Patient risk factors include diabetes and age older than 60 years. In some cases, the neuropathy may progress or become irreversible despite discontinuation of the medications.
Management
Caution is advised during concomitant use of agents with neurotoxic effects. Patients should be monitored closely for symptoms of neuropathy such as burning, tingling, pain, or numbness in the hands and feet. Since the development of peripheral neuropathy may be dose-related for many drugs, the recommended dosages should generally not be exceeded. Consideration should be given to dosage reduction or immediate discontinuation of these medications in patients who develop peripheral neuropathy to limit further damage. If feasible, therapy should generally be reinstituted only after resolution of neuropathy symptoms or return of symptoms to baseline status. In some cases, permanent dosage reductions may be required.
References (4)
- Carrion C, Espinosa E, Herrero A, Garcia B (1995) "Possible vincristine-isoniazid interaction." Ann Pharmacother, 29, p. 201
- Argov Z, Mastaglia FL (1979) "Drug-induced peripheral neuropathies." Br Med J, 1, p. 663-6
- Pharmaceutical Society of Australia (2006) APPGuide online. Australian prescription products guide online. http://www.appco.com.au/appguide/default.asp
- EMEA. European Medicines Agency (2007) EPARs. European Union Public Assessment Reports. http://www.ema.europa.eu/ema/index.jsp?curl=pages/includes/medicines/medicines_landingpage.jsp&mid
Food/lifestyle interactions
Major food/lifestyle interactions
Major:
metroNIDAZOLE Food/Lifestyle
Applies to: Protostat (metronidazole)
Contraindicated
Use of alcohol or products containing alcohol during nitroimidazole therapy may result in a disulfiram-like reaction in some patients. There have been a few case reports involving metronidazole, although data overall are not convincing. The presumed mechanism is inhibition of aldehyde dehydrogenase (ALDH) by metronidazole in a manner similar to disulfiram. Following ingestion of alcohol, inhibition of ALDH results in increased concentrations of acetaldehyde, the accumulation of which can produce an unpleasant physiologic response referred to as the 'disulfiram reaction'. Symptoms include flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, weakness, vertigo, blurred vision, and confusion. Severe reactions may result in respiratory depression, cardiovascular collapse, arrhythmia, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death. However, some investigators have questioned the disulfiram-like properties of metronidazole. One study found neither elevations in blood acetaldehyde nor objective or subjective signs of a disulfiram-like reaction to ethanol in six subjects treated with metronidazole (200 mg three times a day for 5 days) compared to six subjects who received placebo.
Management
Because clear evidence is lacking concerning the safety of ethanol use during nitroimidazole therapy, patients should be apprised of the potential for interaction. Consumption of alcoholic beverages and products containing propylene glycol is specifically contraindicated during and for at least 3 days after completion of metronidazole and benznidazole therapy according to their product labeling.
References (9)
- Giannini AJ, DeFrance DT (1983) "Metronidazole and alcohol: potential for combinative abuse." J Toxicol Clin Toxicol, 20, p. 509-15
- Alexander I (1985) "Alcohol-antabuse syndrome in patients receiving metronidazole during gynaecological treatment." Br J Clin Pract, 39, p. 292-3
- Harries DP, Teale KF, Sunderland G (1990) "Metronidazole and alcohol: potential problems." Scott Med J, 35, p. 179-80
- (2001) "Product Information. Flagyl (metronidazole)." Searle
- Edwards DL, Fink PC, Van Dyke PO (1986) "Disulfiram-like reaction associated with intravenous trimethoprim-sulfamethoxazole and metronidazole." Clin Pharm, 5, p. 999-1000
- Williams CS, Woodcock KR (2000) "Do ethanol and metronidazole interact to produce a disulfiram-like reaction?." Ann Pharmacother, 34, p. 255-7
- Visapaa JP, Tillonen JS, Kaihovaara PS, Salaspuro MP (2002) "Lack of disulfiram-like reaction with metronidazole and ethanol." Ann Pharmacother, 36, p. 971-4
- Krulewitch CJ (2003) "An unexpected adverse drug effect." J Midwifery Womens Health, 48, p. 67-8
- (2017) "Product Information. Benznidazole (benznidazole)." Everett Laboratories Inc
Minor food/lifestyle interactions
Minor:
lazertinib Food/Lifestyle
Applies to: lazertinib
Grapefruit juice may theoretically increase plasma levels of lazertinib, as it does with other drugs metabolized by the CYP450 3A4 enzyme. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. However, the clinical relevance of this potential interaction remains unclear. Studies with strong CYP450 3A4 inhibitors, such as itraconazole, have shown a 1.5-fold increase in the area under the plasma concentration-time curve (AUC) of lazertinib, without any significant changes to the drug's overall safety profile.
References (7)
- Bailey DG, Arnold JMO, Spence JD (1994) "Grapefruit juice and drugs - how significant is the interaction." Clin Pharmacokinet, 26, p. 91-8
- Yamreudeewong W, Henann NE, Fazio A, Lower DL, Cassidy TG (1995) "Drug-food interactions in clinical practice." J Fam Pract, 40, p. 376-84
- Bailey DG, Malcolm J, Arnold O, Spence JD (1998) "Grapefruit juice-drug interactions." Br J Clin Pharmacol, 46, p. 101-10
- Gunston GD, Mehta U (2000) "Potentially serious drug interactions with grapefruit juice." S Afr Med J, 90, p. 41
- (2024) "Product Information. Lazcluze (lazertinib)." Janssen Biotech, Inc.
- (2025) "Product Information. Lazcluze (lazertinib)." Janssen-Cilag Ltd
- (2025) "Product Information. Lazcluze (lazertinib)." Janssen-Cilag Pty Ltd
Disease interactions
16 potential interactions Applies to: 15 conditions, including High Blood Pressure, Heart Failure, Peripheral Neuropathy, Hemodialysis, and Fluid Retention.
Alcoholism
Moderate:
Protostat
The metroNIDAZOLE in Protostat has a moderate potential interaction with Alcoholism.
Nitroimidazoles (e.g., metronidazole, tinidazole, fexinidazole, secnidazole) may inhibit alcohol dehydrogenase and occasionally precipitate a disulfiram-like reaction in patients who consume alcohol while being treated. Symptoms may include abdominal cramps, nausea, vomiting, headache, flushing, rash, weakness, diarrhea, abdominal pain, dizziness, sweating, and hypotension. Patients should be instructed to avoid alcohol-containing products during nitroimidazole therapy and for at least 48 hours (fexinidazole, secnidazole) to 72 hours (metronidazole, tinidazole) after the last dose. Therapy with nitroimidazoles should be administered cautiously in patients who might be prone to acute alcohol intake. An alternative therapy may be appropriate.
Bone Marrow Depression/Low Blood Counts
Major:
Protostat
The metroNIDAZOLE in Protostat has a major potential interaction with Bone Marrow Depression/Low Blood Counts.
The use of nitroimidazoles (e.g., metronidazole, tinidazole) has rarely been associated with hematologic adverse effects such as mild, transient leukopenia, thrombocytopenia, and bone marrow aplasia. The manufacturers recommend that therapy with nitroimidazoles be administered cautiously in patients with evidence of or a history of blood dyscrasias, and that total and differential leukocyte counts be performed before and after treatment with these drugs, particularly in patients receiving repeated courses of therapy.
Central Nervous System Disorders
Major:
Protostat
The metroNIDAZOLE in Protostat has a major potential interaction with Central Nervous System Disorders.
The use of nitroimidazoles (e.g., metronidazole, tinidazole) has been associated with the development of nervous system toxicity including convulsive seizures and dose-related peripheral neuropathy, the latter characterized primarily by numbness or paresthesia of an extremity. Persistent peripheral neuropathy has been reported in some patients treated for prolonged periods. Other neurologic adverse effects include vertigo, incoordination, ataxia, confusion, agitation, hallucinations, and depression. Therapy with nitroimidazoles should be administered cautiously in patients with or predisposed to seizures or other nervous system abnormalities. Nitroimidazole therapy should be discontinued promptly if neurologic disturbances occur.
Fluid Retention
Moderate:
Protostat
The metroNIDAZOLE in Protostat has a moderate potential interaction with Fluid Retention.
Flagyl I.V. RTU (brand of metronidazole ready-to-use injection) contains 14 mEq of sodium per each 500 mg dose of metronidazole. The sodium content should be considered when this product is used in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.
Heart Failure
Moderate:
Protostat
The metroNIDAZOLE in Protostat has a moderate potential interaction with Heart Failure.
Flagyl I.V. RTU (brand of metronidazole ready-to-use injection) contains 14 mEq of sodium per each 500 mg dose of metronidazole. The sodium content should be considered when this product is used in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.
Hemodialysis
Moderate:
Protostat
The metroNIDAZOLE in Protostat has a moderate potential interaction with Hemodialysis.
Metronidazole and its metabolites are moderately removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.
High Blood Pressure
Moderate:
Protostat
The metroNIDAZOLE in Protostat has a moderate potential interaction with High Blood Pressure.
Flagyl I.V. RTU (brand of metronidazole ready-to-use injection) contains 14 mEq of sodium per each 500 mg dose of metronidazole. The sodium content should be considered when this product is used in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.
History of Blood Dyscrasias
Major:
Protostat
The metroNIDAZOLE in Protostat has a major potential interaction with History of Blood Dyscrasias.
The use of nitroimidazoles (e.g., metronidazole, tinidazole) has rarely been associated with hematologic adverse effects such as mild, transient leukopenia, thrombocytopenia, and bone marrow aplasia. The manufacturers recommend that therapy with nitroimidazoles be administered cautiously in patients with evidence of or a history of blood dyscrasias, and that total and differential leukocyte counts be performed before and after treatment with these drugs, particularly in patients receiving repeated courses of therapy.
Hypernatremia
Moderate:
Protostat
The metroNIDAZOLE in Protostat has a moderate potential interaction with Hypernatremia.
Flagyl I.V. RTU (brand of metronidazole ready-to-use injection) contains 14 mEq of sodium per each 500 mg dose of metronidazole. The sodium content should be considered when this product is used in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.
Interstitial Lung Disease
Moderate:
lazertinib
Lazertinib has a moderate potential interaction with Interstitial Lung Disease.
Lazertinib, which is administered in combination with amivantamab, can cause interstitial lung disease (ILD)/pneumonitis. Patients should be monitored for worsening or new symptoms indicative of ILD/pneumonitis, such as dyspnea, cough or fever.
Liver Disease
Moderate:
lazertinib
Lazertinib has a moderate potential interaction with Liver Disease.
Lazertinib has not been studied in patients with severe hepatic impairment (total bilirubin greater than 3 x upper limit of normal and any AST).
Moderate:
Protostat
The metroNIDAZOLE in Protostat has a moderate potential interaction with Liver Disease.
Metronidazole is extensively metabolized by the liver to both pharmacologically active and inactive compounds. The plasma clearance of metronidazole may be decreased and the half-life prolonged in patients with impaired hepatic function. Therapy with metronidazole should be administered cautiously at reduced dosages in patients with severe liver disease.
Noninfectious Colitis
Major:
Protostat
The metroNIDAZOLE in Protostat has a major potential interaction with Noninfectious Colitis.
Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.
Peripheral Neuropathy
Major:
Protostat
The metroNIDAZOLE in Protostat has a major potential interaction with Peripheral Neuropathy.
The use of nitroimidazoles (e.g., metronidazole, tinidazole) has been associated with the development of nervous system toxicity including convulsive seizures and dose-related peripheral neuropathy, the latter characterized primarily by numbness or paresthesia of an extremity. Persistent peripheral neuropathy has been reported in some patients treated for prolonged periods. Other neurologic adverse effects include vertigo, incoordination, ataxia, confusion, agitation, hallucinations, and depression. Therapy with nitroimidazoles should be administered cautiously in patients with or predisposed to seizures or other nervous system abnormalities. Nitroimidazole therapy should be discontinued promptly if neurologic disturbances occur.
Renal Dysfunction
Moderate:
lazertinib
Lazertinib has a moderate potential interaction with Renal Dysfunction.
Lazertinib has not been studied in patients with severe renal dysfunction or end-stage renal disease (eGFR less than 30 mL/min).
Visual Defect/Disturbance
Moderate:
lazertinib
Lazertinib has a moderate potential interaction with Visual Defect/Disturbance.
Lazertinib, which is administered in combination with amivantamab, can cause ocular toxicity, including keratitis. Patients should be monitored for new or worsening eye symptoms and referred promptly to an ophthalmologist.
More resources
lazertinib
A total of 474 drugs are known to interact with lazertinib.
- Lazertinib is in the drug class EGFR inhibitors.
- Lazertinib is used to treat Non Small Cell Lung Cancer.
Protostat
A total of 416 drugs are known to interact with Protostat.
- Protostat is in the following drug classes: amebicides, miscellaneous antibiotics.
-
Protostat is used to treat the following conditions:
- Amebiasis
- Aspiration Pneumonia
- Bacteremia
- Bacterial Infection
- Bacterial Vaginosis
- Balantidium coli
- Bone infection
- Clostridioides difficile Infection
- Deep Neck Infection
- Dental Abscess
- Dientamoeba fragilis
- Diverticulitis
- Dracunculiasis
- Endocarditis
- Giardiasis
- Helicobacter Pylori Infection
- Intraabdominal Infection
- Joint Infection
- Meningitis
- Nongonococcal Urethritis
- Pelvic Inflammatory Disease
- Peritonitis
- Pneumonia
- Pseudomembranous Colitis
- Skin or Soft Tissue Infection
- STD Prophylaxis
- Surgical Prophylaxis
- Trichomoniasis
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
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.