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Drug Interactions between ponatinib and vemurafenib

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

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Interactions between your drugs

Moderate

vemurafenib PONATinib

Applies to: vemurafenib and ponatinib

MONITOR: Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of ponatinib. In vitro, ponatinib has been shown to undergo Phase I metabolism primarily via CYP450 3A4 and to a lesser extent, CYP450 2C8, 2D6 and 3A5. When a single 45 mg dose of ponatinib was administered to healthy subjects following 7 days of continuous daily dosing of 600 mg rifampin, a potent CYP450 3A4 inducer, mean ponatinib peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 42% and 62%, respectively, compared to ponatinib administered alone. Similar results were observed with thrice daily administration of 100 mg oral phenytoin, another potent CYP450 3A4 inducer, using physiologically based pharmacokinetic modeling. The extent to which other, less potent CYP450 3A4 inducers may interact with ponatinib is unknown.

MANAGEMENT: The potential for diminished pharmacologic effects of ponatinib should be considered during coadministration with CYP450 3A4 inducers. Alternative treatments may be required if an interaction is suspected.

References (5)
  1. (2024) "Product Information. Iclusig (PONATinib)." Takeda Pharmaceuticals America
  2. (2023) "Product Information. Iclusig (ponatinib)." Ariad Pharmaceuticals Inc
  3. (2024) "Product Information. Iclusig (ponatinib)." Incyte Biosciences UK Ltd
  4. (2024) "Product Information. Iclusig (pONATinib)." Takeda Pharmaceuticals Australia Pty Ltd, 6.0
  5. Morita TO, hanada k (2022) "Physiologically based pharmacokinetic modeling of ponatinib to describe drug-drug interactions in patients with cancer." Cancer Chemother Pharmacol, 90, p. 315-23

Drug and food interactions

Moderate

PONATinib food

Applies to: ponatinib

GENERALLY AVOID: Coadministration with grapefruit juice is likely to increase the plasma concentrations of ponatinib, which is primarily metabolized by CYP450 3A4. However, the interaction has not been studied. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit.

MANAGEMENT: The consumption of grapefruit, grapefruit juice, and supplements that contain grapefruit extract should be avoided during treatment with ponatinib.

References (1)
  1. (2012) "Product Information. Iclusig (ponatinib)." Ariad Pharmaceuticals Inc

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

Multikinase inhibitors

Therapeutic duplication

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

  • ponatinib
  • vemurafenib

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.

Medical Disclaimer