Can you take Mavacamten with Tepotinib?

Mavacamten has a major potential interaction with Arrhythmia.

Mavacamten reduces systolic contraction/left ventricular ejection fraction (LVEF) and can cause heart failure (due to systolic dysfunction) or totally block ventricular function. Patients with a serious intercurrent illness (e.g., serious infection) or arrhythmia (e.g., atrial fibrillation or other uncontrolled tachyarrhythmia) are at greater risk of developing systolic dysfunction and heart failure. Echocardiogram assessments of LVEF and assessments of the patient's clinical status are required before and regularly during therapy; the mavacamten dose should be adjusted accordingly. New/worsening arrhythmia, dyspnea, chest pain, fatigue, palpitations, leg edema, or elevations in N-terminal pro-B-type natriuretic peptide (NT-proBNP) may be signs/symptoms of heart failure; cardiac function should be evaluated. Asymptomatic LVEF reduction, intercurrent illnesses, and arrhythmias require additional dosing considerations. Initiation of mavacamten in patients with LVEF less than 55% is not recommended; mavacamten should be interrupted if LVEF is less than 50% at any visit or if the patient has heart failure symptoms or worsening clinical status.

Mavacamten has a major potential interaction with Infection.

Mavacamten reduces systolic contraction/left ventricular ejection fraction (LVEF) and can cause heart failure (due to systolic dysfunction) or totally block ventricular function. Patients with a serious intercurrent illness (e.g., serious infection) or arrhythmia (e.g., atrial fibrillation or other uncontrolled tachyarrhythmia) are at greater risk of developing systolic dysfunction and heart failure. Echocardiogram assessments of LVEF and assessments of the patient's clinical status are required before and regularly during therapy; the mavacamten dose should be adjusted accordingly. New/worsening arrhythmia, dyspnea, chest pain, fatigue, palpitations, leg edema, or elevations in N-terminal pro-B-type natriuretic peptide (NT-proBNP) may be signs/symptoms of heart failure; cardiac function should be evaluated. Asymptomatic LVEF reduction, intercurrent illnesses, and arrhythmias require additional dosing considerations. Initiation of mavacamten in patients with LVEF less than 55% is not recommended; mavacamten should be interrupted if LVEF is less than 50% at any visit or if the patient has heart failure symptoms or worsening clinical status.

Mavacamten has a moderate potential interaction with Liver Disease.

Mavacamten should be used with caution in patients with severe liver dysfunction (Child-Pugh C); the effect of severe liver dysfunction is unknown. Mavacamten exposure (AUC) increased up to 220% in patients with mild to moderate liver dysfunction (Child-Pugh A or B) compared to patients with normal liver function; however, no additional dose adjustment is needed with the recommended dose titration algorithm and monitoring plan.

Tepotinib has a moderate potential interaction with Liver Disease.

The use of tepotinib may cause hepatotoxicity, sometimes resulting in fatalities. No dosage modification is recommended in patients with mild (Child-Pugh A) or moderate (Child-Pugh B) liver dysfunction. Care should be exercised when using tepotinib in patients with severe liver dysfunction (Child-Pugh C) as its pharmacokinetics and safety have not been studied in this patient population. It is recommended to monitor liver function tests (including ALT, AST, and total bilirubin) prior to the start of therapy, every 2 weeks during the first 3 months of therapy, then once a month or as clinically indicated, with more frequent testing in patients who develop increased transaminases or bilirubin. Tepotinib should be withheld, the dose should be reduced, or therapy should be permanently discontinued based on the severity of the adverse reaction.

Tepotinib has a moderate potential interaction with Pulmonary Impairment.

The use of tepotinib may cause interstitial lung disease (ILD)/pneumonitis, sometimes resulting in fatalities. Care should be exercised when using this drug in patients with preexisting pulmonary impairment. Tepotinib should be immediately withheld in patients with suspected ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis are identified. Patients should be monitored for new/worsening pulmonary symptoms indicative of ILD/pneumonitis.

Mavacamten has a moderate potential interaction with Renal Dysfunction.

Mavacamten should be used with caution in patients with severe renal dysfunction (estimated glomerular filtration rate [eGFR] 15 to 30 mL/min/1.73 m2) and kidney failure (eGFR less than 15 mL/min/1.73 m2, including those on dialysis); the effects of severe renal dysfunction and kidney failure (including patients on dialysis) are unknown. No clinically significant differences in mavacamten pharmacokinetics were observed based on mild to moderate renal dysfunction (eGFR 30 to 89 mL/min/1.73 m2).

Tepotinib has a moderate potential interaction with Renal Dysfunction.

Care should be exercised when using tepotinib in patients with severe renal dysfunction (CrCl less than 30 mL/min) as the recommended dosage has not been established in this patient population. No dosage adjustment is recommended in patients with mild or moderate renal dysfunction (CrCl 30 to 89 mL/min).