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Drug Interactions between revefenacin and Tykerb

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

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Interactions between your drugs

Moderate

lapatinib revefenacin

Applies to: Tykerb (lapatinib) and revefenacin

GENERALLY AVOID: Coadministration of revefenacin with inhibitors of organic anion transporting polypeptide (OATP) 1B1 and/or 1B3 may increase systemic exposure to its active metabolite, which has been reported to be a substrate of the hepatic uptake transporters. No pharmacokinetic data are available, but increased anticholinergic adverse effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary retention, constipation, and glaucoma (onset or exacerbation) may occur. In study patients, revefenacin was rapidly converted to its active metabolite following inhaled administration, and plasma exposures of the metabolite exceeded those of revefenacin by approximately 4- to 6-fold. The activity of the metabolite at target muscarinic receptors is approximately one-third to one-tenth that of revefenacin and could potentially contribute to systemic antimuscarinic effects at therapeutic doses.

MANAGEMENT: Concomitant use of revefenacin with OATP 1B1 and/or 1B3 inhibitors is not recommended.

References

  1. (2018) "Product Information. Yupelri (revefenacin)." Mylan Specialty
  2. (2020) "Product Information. Nexlizet (bempedoic acid-ezetimibe)." Esperion Therapeutics
  3. (2020) "Product Information. Nexletol (bempedoic acid)." Esperion Therapeutics

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Drug and food interactions

Moderate

lapatinib food

Applies to: Tykerb (lapatinib)

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of lapatinib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits.

ADJUST DOSING INTERVAL: Food can significantly increase the oral bioavailability of lapatinib. According to the manufacturer, lapatinib peak plasma concentration (Cmax) was approximately 2.5- and 3-fold higher and systemic exposure (AUC) 3- and 4-fold higher when administered with a low fat meal (5% fat; 500 calories) or with a high-fat meal (50% fat; 1000 calories), respectively, compared to fasting. Dividing the daily dose also resulted in an approximately 2-fold higher systemic exposure at steady state compared to the same total dose administered once daily.

MANAGEMENT: Patients treated with lapatinib should preferably avoid the consumption of grapefruit or grapefruit juice. The manufacturer recommends that lapatinib be administered at least one hour before or one hour after a meal. The lapatinib dose is administered once daily and should not be divided.

References

  1. (2007) "Product Information. Tykerb (lapatinib)." Novartis Pharmaceuticals

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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.

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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