Drug Interaction Report

GENERALLY AVOID: Concomitant use with inducers of CYP450 1A2 may decrease the plasma concentrations and anti-tumor effects of vorasidenib, which is primarily metabolized by the isoenzyme. The moderate CYP450 1A2 inducers, phenytoin or rifampin, are predicted to decrease the steady state peak plasma concentration (Cmax) and systemic exposure (AUC) of vorasidenib by 30% and 40%, respectively.

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

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.

Administration with food may delay the absorption of modafinil (the racemate) and armodafinil (the R-enantiomer) without significantly affecting their overall bioavailability. According to the product labeling, modafinil's absorption may be delayed by approximately one hour if taken with food. Similarly, the time to reach peak plasma concentration (Tmax) of armodafinil may be delayed by approximately 2 to 4 hours in the fed state.