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Drug Interactions between nilotinib and tovorafenib

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

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Interactions between your drugs

Moderate

nilotinib tovorafenib

Applies to: nilotinib and tovorafenib

MONITOR: Coadministration with inducers of CYP450 2C8 may decrease the plasma concentrations and pharmacologic effects of tovorafenib, which has been found in vitro to be primarily metabolized by CYP450 2C8 and aldehyde oxidase, and to a lesser extent, by the isoenzymes CYP450 3A, 2C9, and 2C19. However, data from formal clinical drug interaction studies are not available.

MANAGEMENT: Caution is advised if tovorafenib is to be used concomitantly with CYP450 2C8 inducers. Patients should be monitored for diminished therapeutic effect. Clinical and laboratory monitoring may also be considered whenever a CYP450 2C8 inducer is added to or withdrawn from therapy. Alternative therapy may need to be considered if a drug interaction is suspected.

References (1)
  1. (2024) "Product Information. Ojemda (tovorafenib)." Day One Biopharmaceuticals, Inc.

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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