Drug Interaction Report

MONITOR: Coadministration with potent CYP450 3A4 inducers may decrease the plasma concentrations and pharmacologic effects of selinexor, which is metabolized by the isoenzyme along with multiple UDP-glucuronosyltransferases (UGTs) and glutathione S-transferases (GSTs). However, data are unavailable and so the clinical significance of this interaction is unknown. The extent to which other, less potent inducers of CYP450 3A4 may interact with selinexor is unknown.

MANAGEMENT: Caution and clinical monitoring for reduced therapeutic efficacy are recommended with the concomitant use of selinexor with potent CYP450 3A4 inducers. Alternative treatments may be required if an interaction is suspected.

GENERALLY AVOID: Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.

MANAGEMENT: The combination of ethanol and barbiturates should be avoided.