Drug Interaction Report
3 potential interactions and/or warnings found for the following 2 drugs:
- Mintezol (thiabendazole)
- olaparib
Interactions between your drugs
thiabendazole olaparib
Applies to: Mintezol (thiabendazole), olaparib
MONITOR: Coadministration with olaparib may decrease the plasma concentrations and therapeutic effects of drugs that are substrates of CYP450 1A2 and/or 2B6. The proposed mechanism, based on in vitro data, is increased clearance due to olaparib-mediated induction of CYP450 1A2 and/or 2B6.
MANAGEMENT: Caution is advised if olaparib is used concomitantly with drugs that are substrates of CYP450 1A2 and/or 2B6. Pharmacologic response and serum levels should be monitored more closely whenever olaparib is added to or withdrawn from therapy with these drugs. Dosage adjustments may be required if an interaction is suspected.
References (1)
- EMA. European Medicines Agency. European Union (2013) EMA - List of medicines under additional monitoring. http://www.ema.europa.eu/ema/index.jsp?curl=pages/regulation/document_listing/document_listing_000366.jsp&mid=WC0b01ac058067c852
- (2023) "Product Information. Lynparza (olaparib)." Astra-Zeneca Pharmaceuticals
- (2023) "Product Information. Lynparza (olaparib)." AstraZeneca Canada Inc
- (2024) "Product Information. Lynparza (olaparib)." AstraZeneca Pty Ltd, 003843410 v13.0
- (2024) "Product Information. Lynparza (olaparib)." AstraZeneca UK Ltd
Drug and food interactions
olaparib food
Applies to: olaparib
GENERALLY AVOID: Grapefruit juice may significantly increase the plasma concentrations of olaparib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. In a drug interaction study with 57 patients, olaparib systemic exposure (AUC) was increased approximately 2.7-fold by the potent CYP450 3A4 inhibitor itraconazole. Simulations using physiologically-based pharmacokinetic (PBPK) models suggest that a moderate inhibitor (fluconazole) may increase the AUC of olaparib by 2-fold. The interaction has not been studied with grapefruit juice. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition. Increased exposure to olaparib may increase the risk of adverse effects such as hematologic toxicity, nausea, vomiting, diarrhea, anorexia, dyspepsia, and abdominal pain or discomfort.
MANAGEMENT: Patients treated with olaparib should avoid consumption of grapefruits, grapefruit juice, Seville oranges, and Seville orange juice. Some authorities also recommend avoiding starfruit (carambola) and pomegranate.
References (2)
- (2023) "Product Information. Lynparza (olaparib)." Astra-Zeneca Pharmaceuticals
- (2023) "Product Information. Lynparza (olaparib)." AstraZeneca Canada Inc
- (2024) "Product Information. Lynparza (olaparib)." AstraZeneca Pty Ltd, 003843410 v13.0
- (2024) "Product Information. Lynparza (olaparib)." AstraZeneca UK Ltd
thiabendazole food
Applies to: Mintezol (thiabendazole)
MONITOR: Coadministration with thiabendazole may increase the plasma concentrations of caffeine. The mechanism is thiabendazole inhibition of the CYP450 1A2 metabolism of caffeine. In ten healthy, nonsmoking volunteers, administration of a single 136.5 mg dose of caffeine in combination with a single 500 mg dose of thiabendazole resulted in a nearly 60% increase in the area under the plasma concentration-time curve (AUC) of caffeine compared to administration without thiabendazole. In addition, the half-life of caffeine was increased from 11.9 to 28.6 hours, and oral clearance was reduced by 67% during coadministration with thiabendazole. The formation of paraxanthine from caffeine, which is primarily mediated by CYP450 1A2, was almost completely abolished until after the thiabendazole was cleared from the system.
MANAGEMENT: Patients should be advised that pharmacologic effects of caffeine may be increased during coadministration with thiabendazole.
References (3)
- Bapiro TE, Sayi J, Hasler JA, et al. (2005) "Artemisinin and thiabendazole are potent inhibitors of cytochrome P450 1A2 (CYP1A2) activity in humans." Eur J Clin Pharmacol, 61, p. 755-61
Therapeutic duplication warnings
No duplication 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.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
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