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Drug Interactions between lusutrombopag and Zepatier

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

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Interactions between your drugs

Moderate

elbasvir lusutrombopag

Applies to: Zepatier (elbasvir / grazoprevir) and lusutrombopag

MONITOR: Coadministration with inhibitors of P-glycoprotein (P-gp) and/or breast cancer resistance protein (BCRP) may increase the plasma concentrations of lusutrombopag, which is a substrate of both efflux transporter proteins. Coadministration with cyclosporine, a P-gp and BCRP dual inhibitor, increased lusutrombopag peak plasma concentration (Cmax) and systemic exposure (AUC) by approximately 20% each compared with lusutrombopag administration alone.

MANAGEMENT: Caution is advised if lusutrombopag is prescribed in combination with P-gp and/or BCRP inhibitors. Pharmacologic response to lusutrombopag should be monitored more closely following initiation, discontinuation, or change of dosage of the concomitant P-gp or BCRP inhibitor.

References (1)
  1. EMA. European Medicines Agency. European Union (2013) EMA - List of medicines under additional monitoring. http://www.ema.europa.eu/ema/index.jsp?curl=pages/regulation/document_listing/document_listing_000366.jsp&mid=WC0b01ac058067c852
Moderate

grazoprevir lusutrombopag

Applies to: Zepatier (elbasvir / grazoprevir) and lusutrombopag

MONITOR: Coadministration with inhibitors of P-glycoprotein (P-gp) and/or breast cancer resistance protein (BCRP) may increase the plasma concentrations of lusutrombopag, which is a substrate of both efflux transporter proteins. Coadministration with cyclosporine, a P-gp and BCRP dual inhibitor, increased lusutrombopag peak plasma concentration (Cmax) and systemic exposure (AUC) by approximately 20% each compared with lusutrombopag administration alone.

MANAGEMENT: Caution is advised if lusutrombopag is prescribed in combination with P-gp and/or BCRP inhibitors. Pharmacologic response to lusutrombopag should be monitored more closely following initiation, discontinuation, or change of dosage of the concomitant P-gp or BCRP inhibitor.

References (1)
  1. EMA. European Medicines Agency. European Union (2013) EMA - List of medicines under additional monitoring. http://www.ema.europa.eu/ema/index.jsp?curl=pages/regulation/document_listing/document_listing_000366.jsp&mid=WC0b01ac058067c852

Drug and food interactions

Minor

grazoprevir food

Applies to: Zepatier (elbasvir / grazoprevir)

Food does not appear to have clinically significant effects on the pharmacokinetics of elbasvir and grazoprevir. When a single 50 mg-100 mg dose of elbasvir-grazoprevir was administered to healthy study subjects with a high-fat meal (900 kcal; 500 kcal from fat), elbasvir peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 15% and 11%, respectively, while grazoprevir Cmax and AUC increased by 2.8- and 1.5-fold, respectively, compared to administration under fasting conditions. According to the product labeling, elbasvir-grazoprevir may be administered with or without food.

References (1)
  1. (2016) "Product Information. Zepatier (elbasvir-grazoprevir)." Merck & Co., 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.

See also

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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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