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Drug Interactions between pirtobrutinib and zanubrutinib

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

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Interactions between your drugs

Major

zanubrutinib pirtobrutinib

Applies to: zanubrutinib and pirtobrutinib

Consumer information for this interaction is not currently available.

MONITOR CLOSELY: Coadministration of zanubrutinib with drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. Serious and fatal hemorrhagic events have been reported during zanubrutinib monotherapy. Grade 3 or higher bleeding events including intracranial and gastrointestinal hemorrhage, hematuria, and hemothorax have been reported in up to 4.6% of patients treated with zanubrutinib monotherapy, with fatalities occurring in up to 0.3% of patients. Overall, bleeding events of any grade, including purpura and petechiae, have occurred in patients both with and without concomitant antiplatelet or anticoagulation therapy. Coadministration of zanubrutinib with antiplatelet or anticoagulant medications may potentiate the risk of hemorrhage. The mechanism for the bleeding events is not well understood, although treatment with zanubrutinib commonly causes thrombocytopenia. Grade 3 or 4 cytopenias including neutropenia, thrombocytopaenia, and anemia have been reported during treatment with zanubrutinib monotherapy.

MANAGEMENT: Use of zanubrutinib, either alone or concomitantly with other medications that interfere with platelet function or coagulation may potentiate risk of bleeding complications. Concomitant use should be done with caution. Close clinical and laboratory monitoring for bleeding complications is recommended during therapy. Patients should be advised to promptly report any signs and symptoms of bleeding to their physician. Discontinue zanubrutinib if intracranial hemorrhage of any grade occurs. Refer to the product labeling further dosage adjustment, and/or withholding treatment is advised if Grade 3 or higher adverse reactions occur. Additional consultation with individual package labeling, as well as relevant institutional protocols, may be advisable for further guidance.

Drug and food interactions

Major

zanubrutinib food

Applies to: zanubrutinib

Grapefruit juice and Seville orange juice can increase the blood levels of zanubrutinib. This may increase side effects such as rash, diarrhea, constipation, cough, hemorrhage, development of other cancers, abnormal heart rhythm, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. You should avoid the consumption of Seville oranges, Seville orange juice, grapefruit and grapefruit juice during treatment with zanubrutinib. Be sure to take the medication at approximately the same time(s) everyday to maintain consistent blood levels and effects. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Major

pirtobrutinib food

Applies to: pirtobrutinib

Consumption of grapefruit, grapefruit juice, and supplements that contain grapefruit should be avoided during treatment with pirtobrutinib as they may increase the blood levels of pirtobrutinib. This may increase the risk of side effects such as infection, bruising, bleeding, fatigue, muscle pain, diarrhea, swelling, and difficulty breathing. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Btk inhibitors

Therapeutic duplication

The recommended maximum number of medicines in the 'BTK inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'BTK inhibitors' category:

  • pirtobrutinib
  • zanubrutinib

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

See also

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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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