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Drug Interactions between niraparib and Viekira XR

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

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Interactions between your drugs

Moderate

ombitasvir niraparib

Applies to: Viekira XR (dasabuvir / ombitasvir / paritaprevir / ritonavir) and niraparib

MONITOR: Coadministration with niraparib may increase the plasma concentrations of drugs that are substrates of the breast cancer resistance protein (BCRP) transporter. The proposed mechanism is BCRP inhibition by niraparib. In vitro studies have shown that niraparib is able to inhibit BCRP, but a clinically meaningful interaction is unlikely.

MANAGEMENT: Caution is recommended if niraparib is used in combination with substrates of the breast cancer resistance protein (BCRP) transporter such as irinotecan, rosuvastatin, simvastatin, atorvastatin, and/or methotrexate. Monitoring for signs and symptoms of increased exposure to the BCRP substrate should be considered whenever niraparib is added to or withdrawn from therapy.

References (6)
  1. (2023) "Product Information. Akeega (abiraterone-niraparib)." Janssen Biotech, Inc.
  2. (2023) "Product Information. Zejula (niraparib)." GlaxoSmithKline
  3. (2023) "Product Information. Zejula (niraparib)." GlaxoSmithKline Inc
  4. (2023) "Product Information. Akeega (abiraterone-niraparib)." Janssen Inc
  5. (2023) "Product Information. Zejula (niraparib)." GlaxoSmithKline Australia Pty Ltd
  6. (2023) "Product Information. Zejula (niraparib)." GlaxoSmithKline UK Ltd
Minor

ritonavir niraparib

Applies to: Viekira XR (dasabuvir / ombitasvir / paritaprevir / ritonavir) and niraparib

Coadministration of niraparib with a P-glycoprotein (P-gp) and/or Breast Cancer Resistance Protein (BCRP) inhibitor may increase the plasma concentration of niraparib, which is a substrate of these efflux transporters. However, due to the high permeability and bioavailability of niraparib, the risk of a clinically relevant interaction with inhibitors of these transporters is unlikely. No dose adjustment is recommended if a P-gp and/or BCRP inhibitor is added to treatment with niraparib.

References (6)
  1. (2023) "Product Information. Akeega (abiraterone-niraparib)." Janssen Biotech, Inc.
  2. (2023) "Product Information. Zejula (niraparib)." GlaxoSmithKline
  3. (2023) "Product Information. Zejula (niraparib)." GlaxoSmithKline Inc
  4. (2023) "Product Information. Akeega (abiraterone-niraparib)." Janssen Inc
  5. (2023) "Product Information. Zejula (niraparib)." GlaxoSmithKline Australia Pty Ltd
  6. (2023) "Product Information. Zejula (niraparib)." GlaxoSmithKline UK Ltd
Minor

paritaprevir niraparib

Applies to: Viekira XR (dasabuvir / ombitasvir / paritaprevir / ritonavir) and niraparib

Coadministration of niraparib with a P-glycoprotein (P-gp) and/or Breast Cancer Resistance Protein (BCRP) inhibitor may increase the plasma concentration of niraparib, which is a substrate of these efflux transporters. However, due to the high permeability and bioavailability of niraparib, the risk of a clinically relevant interaction with inhibitors of these transporters is unlikely. No dose adjustment is recommended if a P-gp and/or BCRP inhibitor is added to treatment with niraparib.

References (6)
  1. (2023) "Product Information. Akeega (abiraterone-niraparib)." Janssen Biotech, Inc.
  2. (2023) "Product Information. Zejula (niraparib)." GlaxoSmithKline
  3. (2023) "Product Information. Zejula (niraparib)." GlaxoSmithKline Inc
  4. (2023) "Product Information. Akeega (abiraterone-niraparib)." Janssen Inc
  5. (2023) "Product Information. Zejula (niraparib)." GlaxoSmithKline Australia Pty Ltd
  6. (2023) "Product Information. Zejula (niraparib)." GlaxoSmithKline UK Ltd
Minor

dasabuvir niraparib

Applies to: Viekira XR (dasabuvir / ombitasvir / paritaprevir / ritonavir) and niraparib

Coadministration of niraparib with a P-glycoprotein (P-gp) and/or Breast Cancer Resistance Protein (BCRP) inhibitor may increase the plasma concentration of niraparib, which is a substrate of these efflux transporters. However, due to the high permeability and bioavailability of niraparib, the risk of a clinically relevant interaction with inhibitors of these transporters is unlikely. No dose adjustment is recommended if a P-gp and/or BCRP inhibitor is added to treatment with niraparib.

References (6)
  1. (2023) "Product Information. Akeega (abiraterone-niraparib)." Janssen Biotech, Inc.
  2. (2023) "Product Information. Zejula (niraparib)." GlaxoSmithKline
  3. (2023) "Product Information. Zejula (niraparib)." GlaxoSmithKline Inc
  4. (2023) "Product Information. Akeega (abiraterone-niraparib)." Janssen Inc
  5. (2023) "Product Information. Zejula (niraparib)." GlaxoSmithKline Australia Pty Ltd
  6. (2023) "Product Information. Zejula (niraparib)." GlaxoSmithKline UK Ltd

Drug and food interactions

Moderate

ritonavir food

Applies to: Viekira XR (dasabuvir / ombitasvir / paritaprevir / ritonavir)

ADJUST DOSING INTERVAL: Administration with food may modestly affect the bioavailability of ritonavir from the various available formulations. When the oral solution was given under nonfasting conditions, peak ritonavir concentrations decreased 23% and the extent of absorption decreased 7% relative to fasting conditions. Dilution of the oral solution (within one hour of dosing) with 240 mL of chocolate milk or a nutritional supplement (Advera or Ensure) did not significantly affect the extent and rate of ritonavir absorption. When a single 100 mg dose of the tablet was administered with a high-fat meal (907 kcal; 52% fat, 15% protein, 33% carbohydrates), approximately 20% decreases in mean peak concentration (Cmax) and systemic exposure (AUC) were observed relative to administration after fasting. Similar decreases in Cmax and AUC were reported when the tablet was administered with a moderate-fat meal. In contrast, the extent of absorption of ritonavir from the soft gelatin capsule formulation was 13% higher when administered with a meal (615 KCal; 14.5% fat, 9% protein, and 76% carbohydrate) relative to fasting.

MANAGEMENT: Ritonavir should be taken with meals to enhance gastrointestinal tolerability.

References (1)
  1. (2001) "Product Information. Norvir (ritonavir)." Abbott Pharmaceutical
Moderate

paritaprevir food

Applies to: Viekira XR (dasabuvir / ombitasvir / paritaprevir / ritonavir)

ADJUST DOSING INTERVAL: Food enhances the oral bioavailability of ombitasvir, paritaprevir, ritonavir, and dasabuvir. Relative to fasting conditions, administration of ombitasvir, paritaprevir, ritonavir, and dasabuvir with a moderate-fat meal (approximately 600 Kcal; 20% to 30% calories from fat) increased the mean systemic exposure (AUC) by 82%, 211%, 49%, and 30%, respectively. Relative to fasting conditions, administration of ombitasvir, paritaprevir, ritonavir, and dasabuvir with a high-fat meal (approximately 900 Kcal; with 60% calories from fat) increased the mean AUC by 76%, 180%, 44%, and 22%, respectively.

MANAGEMENT: Ombitasvir/paritaprevir/ritonavir plus dasabuvir should always be administered with a meal. The fat or calorie content does not matter.

References (1)
  1. (2022) "Product Information. Viekira Pak (dasabuvir/ombitasvir/paritaprev/ritonav)." AbbVie US LLC

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

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