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Drug Interactions between pexidartinib and ulipristal

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

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Interactions between your drugs

Major

ulipristal pexidartinib

Applies to: ulipristal and pexidartinib

GENERALLY AVOID: Coadministration with potent and moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of ulipristal acetate and its pharmacologically active metabolite. Based on in vitro and pharmacokinetic data, ulipristal acetate is thought to be primarily metabolized by CYP450 3A4 to mono-demethylated and di-demethylated metabolites. When a single 30 mg dose of ulipristal acetate was administered following a 9-day treatment with 600 mg once daily of rifampin, a potent CYP450 3A4 inducer, ulipristal acetate peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 90% and 93% respectively, while half-life decreased by 2.2-fold. The Cmax and AUC of monodemethyl-ulipristal acetate, the active metabolite, decreased by 84% and 90%, respectively. The interaction has not been studied with other, less potent inducers.

MANAGEMENT: Concomitant use of ulipristal acetate with potent and moderate CYP450 3A4 inducers should generally be avoided due to the potential for loss of therapeutic efficacy. For patients who have used enzyme-inducing drugs within the past 4 weeks and are seeking emergency contraception, ulipristal acetate is not recommended and a non-hormonal method (i.e. a copper intrauterine device (Cu-IUD)) should be considered.

References (6)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."
  3. (2022) "Product Information. Ella (ulipristal)." Afaxys Inc.
  4. Cerner Multum, Inc. (2015) "Canadian Product Information."
  5. (2021) "Product Information. Esmya (ulipristal)." Gedeon Richter (UK) Ltd
  6. (2021) "Product Information. EllaOne (ulipristal)." HRA Pharma UK & Ireland Ltd

Drug and food interactions

Major

pexidartinib food

Applies to: pexidartinib

ADJUST DOSING INTERVAL: The presence of food may increase the absorption and toxicity of pexidartinib. Administration of pexidartinib with a high-fat meal increased peak plasma concentration (Cmax) and systemic exposure (AUC) by 100% and prolonged the time to reach peak plasma concentration (Tmax) by 2.5 hours.

GENERALLY AVOID: Grapefruit or grapefruit juice may increase the plasma concentration and risk of adverse effects of pexidartinib, including potentially fatal hepatotoxicity. The mechanism is inhibition of CYP450 3A4-mediated metabolism of pexidartinib by certain compounds present in grapefruits. Concomitant administration of itraconazole, a strong CYP450 3A4 inhibitor, increased pexidartinib peak plasma concentration (Cmax) and systemic exposure (AUC) by 48% and 70%, respectively.

MANAGEMENT: Pexidartinib should be administered on an empty stomach, at least one hour before or two hours after a meal or snack. Consumption of grapefruit or grapefruit juice should generally be avoided during pexidartinib therapy. If concomitant use is unavoidable, the dose of pexidartinib should be reduced according to the manufacturer's recommendations. If concomitant use of grapefruit or grapefruit juice is discontinued, the dose of pexidartinib may be increased (after 3 plasma half-lives of a strong CYP450 3A4 inhibitor) to the dose that was used prior to consumption of grapefruit or grapefruit juice.

References (1)
  1. (2019) "Product Information. Turalio (pexidartinib)." Daiichi Sankyo, Inc.

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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