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Drug Interactions between nilotinib and polatuzumab vedotin

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

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Interactions between your drugs

Moderate

nilotinib polatuzumab vedotin

Applies to: nilotinib and polatuzumab vedotin

MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase exposure to unconjugated monomethyl auristatin E (MMAE), the anti-mitotic and cytotoxic component of polatuzumab vedotin. MMAE is a substrate for CYP450 3A4. Concomitant use of polatuzumab vedotin with ketoconazole, a potent CYP450 3A4 inhibitor, is predicted to increase unconjugated MMAE exposure (AUC) by 45% according to the product labeling. No data are available for other, less potent CYP450 3A4 inhibitors.

MANAGEMENT: Caution is advised when polatuzumab vedotin is used concomitantly with CYP450 3A4 inhibitors. Patients should be monitored for development or exacerbation of toxicities such as peripheral neuropathy, myelosuppression, opportunistic infections, tumor lysis syndrome and hepatotoxicity, and the dosing of polatuzumab vedotin adjusted or withheld as necessary in accordance with the product labeling.

References (1)
  1. (2019) "Product Information. Polivy (polatuzumab vedotin)." Genentech

Drug and food interactions

Major

nilotinib food

Applies to: nilotinib

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of nilotinib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. Because nilotinib is associated with concentration-dependent prolongation of the QT interval, increased levels may potentiate the risk of ventricular arrhythmias such as torsade de pointes and sudden death.

ADJUST DOSING INTERVAL: Food increases the oral bioavailability of nilotinib. The mechanism of interaction is unknown. Compared to the fast state, nilotinib systemic exposure (AUC) increased by 82% when the dose was given 30 minutes after a high-fat meal. Because nilotinib is associated with concentration-dependent prolongation of the QT interval, increased levels may potentiate the risk of ventricular arrhythmias such as torsade de pointes and sudden death.

MANAGEMENT: Patients treated with nilotinib should avoid consumption of grapefruit, grapefruit juice, and any supplement containing grapefruit extract. In addition, no food should be consumed for at least 2 hours before and 1 hour after a nilotinib dose.

References (1)
  1. (2007) "Product Information. Tasigna (nilotinib)." Novartis Pharmaceuticals

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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