Can you take Maraviroc with Pacritinib?

Pacritinib has a moderate potential interaction with Arrhythmia.

Pacritinib can cause a QT prolongation of greater than 500 msec, and patients receiving this drug were more likely to develop a QT prolongation of at least 60 msec from baseline (compared to the control group) in clinical trials. This agent should be avoided in patients with QT intervals greater than 480 msec at baseline, and/or in those who are taking medications known to prolong the QTc interval. Hypokalemia should be corrected before initiating and during therapy with this agent. QT prolongation occurring during treatment should be managed with treatment interruption and electrolyte management. Periodic monitoring of ECGs and electrolytes is recommended in these patients.

Pacritinib has a moderate potential interaction with Bleeding Associated with Coagulation Defect.

Serious episodes of bleeding, including those requiring transfusion/invasive intervention, and some leading to fatal bleeding events have been reported in patients treated with pacritinib. Platelet counts should be periodically assessed, monitoring for signs of bleeding (when indicated); hemorrhage should be managed with medical intervention, dose reductions, intermittent interruptions, and/or permanent treatment discontinuations. It is recommended to withhold pacritinib for 7 days prior to planned surgery/invasive procedure.

Pacritinib has a moderate potential interaction with Bleeding Disorder.

Serious episodes of bleeding, including those requiring transfusion/invasive intervention, and some leading to fatal bleeding events have been reported in patients treated with pacritinib. Platelet counts should be periodically assessed, monitoring for signs of bleeding (when indicated); hemorrhage should be managed with medical intervention, dose reductions, intermittent interruptions, and/or permanent treatment discontinuations. It is recommended to withhold pacritinib for 7 days prior to planned surgery/invasive procedure.

Pacritinib has a major potential interaction with Cardiovascular Conditions and Disorders.

In a major safety study of a Janus kinase (JAK) inhibitor, tofacitinib, in rheumatoid arthritis patients 50 years and older with at least 1 cardiovascular risk factor, higher rates of all-cause mortality (including sudden cardiovascular death) and major adverse cardiovascular events (MACE) (defined as cardiovascular death, myocardial infarction, and stroke) were observed with the JAK inhibitor when compared with tumor necrosis factor (TNF) blockers. Patients who were current or past smokers had an additional increased risk. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including baricitinib, upadacitinib, ruxolitinib, fedratinib, ritlecitinib, deuruxolitinib, and pacritinib. Consider the benefits and risks for each individual patient prior and during treatment with JAK inhibitors, especially in patients with other cardiovascular risk factors, history of cardiovascular events, and patients who are current or past smokers. Patients should be informed about the symptoms of serious cardiovascular events and what to do if they occur.

Maraviroc has a moderate potential interaction with Cardiovascular Conditions and Disorders.

Cardiovascular events (including myocardial ischemia and/or infarction) were reported in 11 therapy-experienced patients (1.3%) receiving maraviroc during phase 3 trials; these patients generally had cardiac disease or cardiac risk factors before using maraviroc. Patients with cardiovascular comorbidities, history of/risk factors for postural hypotension, or receiving concurrent medication known to lower blood pressure, could be at increased risk of cardiovascular adverse events triggered by postural hypotension; additional monitoring may be necessary.

Pacritinib has a major potential interaction with Diarrhea.

Severe diarrhea, sometimes requiring discontinuation of treatment, has occurred in patients treated with pacritinib. Preexisting diarrhea should be controlled prior to starting treatment with pacritinib. Antidiarrheal agents should be promptly used to treat diarrhea at the first onset of symptoms. Antidiarrheal agents, fluid replacement, and/or dose modification should be used to manage diarrhea. Reducing or interrupting pacritinib should be considered in patients with significant diarrhea (despite optimal supportive care).

Maraviroc has a moderate potential interaction with Hypotension.

Cardiovascular events (including myocardial ischemia and/or infarction) were reported in 11 therapy-experienced patients (1.3%) receiving maraviroc during phase 3 trials; these patients generally had cardiac disease or cardiac risk factors before using maraviroc. Patients with cardiovascular comorbidities, history of/risk factors for postural hypotension, or receiving concurrent medication known to lower blood pressure, could be at increased risk of cardiovascular adverse events triggered by postural hypotension; additional monitoring may be necessary.

Pacritinib has a major potential interaction with Infection.

Serious and sometimes fatal infections due to bacterial, mycobacterial, invasive fungal, viral, or other opportunistic pathogens have been reported in patients receiving pacritinib. It is recommended to avoid the use of pacritinib in patients with an active, serious infection, including localized infections and to consider the risks and benefits before starting treatment. Patients should be closely monitored for the development of signs and symptoms of infection during and after treatment. Treatment should be interrupted if a patient develops a serious infection, an opportunistic infection, or sepsis and appropriate therapy should be instituted according to clinical guidelines. Close monitoring is recommended.

Maraviroc has a major potential interaction with Liver Disease.

Hepatotoxicity has been reported with the use of maraviroc. Severe rash or evidence of systemic allergic reaction (e.g., fever, eosinophilia, elevated immunoglobulin E [IgE]) prior to the development of hepatotoxicity may occur. Patients with signs/symptoms of hepatitis or allergic reaction after use of maraviroc should be evaluated immediately. Appropriate laboratory testing (including ALT, AST, and bilirubin) should be conducted before starting maraviroc and periodically during therapy as clinically indicated. Additional monitoring may be necessary when administering maraviroc to patients with preexisting liver dysfunction or who are coinfected with hepatitis B and/or C virus. The safety and efficacy of maraviroc has not been studied in patients with significant underlying liver disorders; caution is recommended.

Maraviroc has a major potential interaction with Renal Dysfunction.

An increased risk of postural hypotension may occur in patients with severe renal dysfunction or in those with ESRD due to increased exposure to maraviroc in some patients. This drug should be used with caution in these patients only if they are not receiving a concomitant potent CYP450 3A inhibitor or inducer, but maraviroc should only be considered for patients with severe renal dysfunction or ESRD when no alternative treatment options are available. The dose should be reduced if any symptoms of postural hypotension occur. No studies have been performed in patients with severe renal dysfunction (CrCl less than 30 mL/min) or ESRD who are concomitantly taking potent CYP450 3A inhibitors or inducers, and maraviroc is contraindicated in these patients.

Pacritinib has a major potential interaction with Smoking.

Malignancies (including lymphomas and solid tumors) have been reported in patients treated with tofacitinib, baricitinib, upadacitinib, deuruxolitinib and other Janus kinase (JAK) inhibitors used to treat inflammatory conditions. Patients who are current or past smokers are at additional increased risk of malignancies. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including ruxolitinib, pacritinib, and fedratinib. Before starting or continuing therapy, the benefits and risks for the individual patient should be considered, especially in patients with a known malignancy (other than successfully treated nonmelanoma skin cancer), patients who develop a malignancy during therapy, and patients who are current or past smokers. Periodic skin examination is recommended for patients who are at increased risk for skin cancer.

Pacritinib has a major potential interaction with Smoking.

In a major safety study of a Janus kinase (JAK) inhibitor, tofacitinib, in rheumatoid arthritis patients 50 years and older with at least 1 cardiovascular risk factor, higher rates of all-cause mortality (including sudden cardiovascular death) and major adverse cardiovascular events (MACE) (defined as cardiovascular death, myocardial infarction, and stroke) were observed with the JAK inhibitor when compared with tumor necrosis factor (TNF) blockers. Patients who were current or past smokers had an additional increased risk. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including baricitinib, upadacitinib, ruxolitinib, fedratinib, ritlecitinib, deuruxolitinib, and pacritinib. Consider the benefits and risks for each individual patient prior and during treatment with JAK inhibitors, especially in patients with other cardiovascular risk factors, history of cardiovascular events, and patients who are current or past smokers. Patients should be informed about the symptoms of serious cardiovascular events and what to do if they occur.

Pacritinib has a major potential interaction with Thrombotic/Thromboembolic Disorder.

Thrombosis (including deep venous thrombosis, pulmonary embolism, cerebral venous sinus thrombosis, and arterial thrombosis) has occurred in patients treated for inflammatory conditions with Janus kinase (JAK) inhibitors, including baricitinib, tofacitinib, deuruxolitinib and upadacitinib. Many of these adverse events were serious and some resulted in death. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including ruxolitinib, fedratinib, and pacritinib. In general, JAK inhibitors should be avoided in patients who may be at increased risk of thrombosis. Tofacitinib should be used at the lowest effective dose and for the shortest duration needed to achieve/maintain therapeutic response when treating ulcerative colitis. If symptoms of thrombosis occur in any patients receiving JAK inhibitors, treatment should be discontinued and patients should be evaluated promptly and treated appropriately.

Pacritinib has a moderate potential interaction with Ventricular Arrhythmia.

Pacritinib can cause a QT prolongation of greater than 500 msec, and patients receiving this drug were more likely to develop a QT prolongation of at least 60 msec from baseline (compared to the control group) in clinical trials. This agent should be avoided in patients with QT intervals greater than 480 msec at baseline, and/or in those who are taking medications known to prolong the QTc interval. Hypokalemia should be corrected before initiating and during therapy with this agent. QT prolongation occurring during treatment should be managed with treatment interruption and electrolyte management. Periodic monitoring of ECGs and electrolytes is recommended in these patients.