Drug Interaction Report

ADJUST DOSING INTERVAL: The safety and efficacy of recombinant human granulocyte colony-stimulating factors (rhG-CSF) administered simultaneously with cytotoxic agents, including cancer chemotherapy, have not been established. Theoretical concerns exist regarding their concomitant administration because hematopoietic growth factors stimulate myeloid cell proliferation while antineoplastic agents primarily target rapidly dividing cells.

MANAGEMENT: The prescribing information for pegfilgrastim, eflapegrastim, and efbemalenograstim alfa recommends that these products not be administered between 14 days before and 24 hours after antineoplastic agents.

ADJUST DOSING INTERVAL: Administration of trifluridine-tipiracil with a standardized high-fat, high-calorie meal has been shown to decrease trifluridine peak plasma concentration (Cmax) as well as tipiracil Cmax and systemic exposure (AUC) by approximately 40% compared to administration in a fasting state in patients with cancer given a single 35 mg/m2 dose. No change in trifluridine AUC was observed.

MANAGEMENT: Based on the observed correlation between increases in the Cmax of trifluridine and decreases in neutrophil counts, trifluridine-tipiracil should be taken within one hour after completion of the morning and evening meals.