Drug Interaction Report

MONITOR: Coadministration with rucaparib may increase the plasma concentrations and the risk of adverse effects of drugs that are substrates of breast cancer resistance protein (BCRP) (e.g., rosuvastatin) and/or uridine diphosphate glucuronosyltransferase (UGT) 1A1 (e.g., deferasirox). The proposed mechanism, based on in vitro data, is decreased clearance due to rucaparib-mediated inhibition of these transport proteins.

MANAGEMENT: Caution is advised if rucaparib is used with drugs that are substrates of BCRP and/or UGT1A1, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring should be considered whenever rucaparib is added to or withdrawn from therapy with these drugs. Patients should be monitored for the development of adverse effects.

ADJUST DOSING INTERVAL: Food may reduce the oral bioavailability of afatinib. According to the product labeling, administration of afatinib with a high-fat meal decreased peak plasma concentration (Cmax) by 50% and systemic exposure (AUC) by 39% compared to administration in the fasted state.

MANAGEMENT: Afatinib should be taken at least 1 hour before or 2 hours after a meal.