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Drug Interactions between olaparib and voriconazole

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

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Interactions between your drugs

Major

voriconazole olaparib

Applies to: voriconazole and olaparib

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of olaparib, which is primarily metabolized by the isoenzyme. In a drug interaction study with 57 patients, mean olaparib peak plasma concentration (Cmax) and systemic exposure (AUC) increased by approximately 1.4- and 2.7-fold, respectively, during coadministration with the potent CYP450 3A4 inhibitor itraconazole. Increased exposure to olaparib may increase the risk of adverse effects such as hematologic toxicity, nausea, vomiting, diarrhea, anorexia, dyspepsia, and abdominal pain or discomfort.

MANAGEMENT: Concomitant use of olaparib with potent CYP450 3A4 inhibitors should be avoided whenever possible. Some authorities recommend avoiding concomitant use of olaparib during and for 2 weeks after treatment with itraconazole. If coadministration is required, the olaparib dosage should be reduced to 100 mg twice a day. Once the CYP450 3A4 inhibitor has been discontinued for 3 to 5 elimination half-lives, the usual olaparib dose should be resumed.

References (5)
  1. (2023) "Product Information. Lynparza (olaparib)." Astra-Zeneca Pharmaceuticals
  2. (2024) "Product Information. Sporanox (itraconazole)." Janssen Pharmaceuticals
  3. (2024) "Product Information. Lynparza (olaparib)." AstraZeneca Pty Ltd
  4. (2024) "Product Information. Lynparza (olaparib)." AstraZeneca Canada Inc
  5. (2024) "Product Information. Lynparza (olaparib)." AstraZeneca UK Ltd, 2

Drug and food interactions

Major

olaparib food

Applies to: olaparib

GENERALLY AVOID: Grapefruit juice may significantly increase the plasma concentrations of olaparib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. In a drug interaction study with 57 patients, mean olaparib systemic exposure (AUC) was increased approximately 2.7-fold by the potent CYP450 3A4 inhibitor itraconazole. Simulations using physiologically-based pharmacokinetic (PBPK) models suggest that a moderate inhibitor (fluconazole) may increase the AUC of olaparib by 2.2-fold. The interaction has not been studied with grapefruit juice. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition. Increased exposure to olaparib may increase the risk of adverse effects such as hematologic toxicity, nausea, vomiting, diarrhea, anorexia, dyspepsia, and abdominal pain or discomfort.

MANAGEMENT: Food containing grapefruit, grapefruit juice, Seville orange (a citrus relative of the grapefruit), or Seville orange juice should be avoided during treatment with olaparib. Some authorities also recommend avoiding starfruit (carambola) and pomegranate.

References (4)
  1. (2023) "Product Information. Lynparza (olaparib)." Astra-Zeneca Pharmaceuticals
  2. (2024) "Product Information. Lynparza (olaparib)." AstraZeneca Pty Ltd
  3. (2024) "Product Information. Lynparza (olaparib)." AstraZeneca Canada Inc
  4. (2024) "Product Information. Lynparza (olaparib)." AstraZeneca UK Ltd, 2
Moderate

voriconazole food

Applies to: voriconazole

ADJUST DOSING INTERVAL: Food reduces the oral absorption and bioavailability of voriconazole. According to the product labeling, administration of multiple doses of voriconazole with high-fat meals decreased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 34% and 24%, respectively, when the drug is administered as a tablet, and by 58% and 37%, respectively, when administered as the oral suspension.

MANAGEMENT: To ensure maximal oral absorption, voriconazole tablets and oral suspension should be taken at least one hour before or after a meal.

References (2)
  1. (2002) "Product Information. VFEND (voriconazole)." Pfizer U.S. Pharmaceuticals
  2. Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT (2009) "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm, 66, p. 1438-67

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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