Drug Interaction Report

GENERALLY AVOID: Concomitant use with potent inhibitors of CYP450 1A2 may increase the plasma concentrations of vorasidenib, which is primarily metabolized by the isoenzyme, and the risk for potential adverse reactions, such as hepatotoxicity. When coadministered with fluvoxamine, a potent CYP450 1A2 inhibitor, vorasidenib Cmax and AUC are predicted to increase by 5-fold or more.

MANAGEMENT: Concomitant use of vorasidenib with potent CYP450 1A2 inhibitors should be avoided.

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

GENERALLY AVOID: Due to induction of CYP450 1A2, the isoenzyme primarily responsible for the metabolic clearance of vorasidenib, smoking tobacco during treatment with vorasidenib may decrease its plasma concentrations and anti-tumor effect. Clinical and pharmacokinetic data are currently lacking.

MANAGEMENT: Patient should be advised to avoid smoking tobacco during treatment with vorasidenib because it may reduce efficacy of the therapy.