Drug Interaction Report

MONITOR: Coadministration with osimertinib may increase the exposure of breast cancer resistance protein (BCRP) transporter substrates. In vitro studies have shown that osimertinib is a competitive inhibitor of BCRP. In a clinical pharmacokinetic study, concomitant use of osimertinib with the BCRP substrate rosuvastatin increased the systemic exposure (AUC) and peak plasma concentration (Cmax) of rosuvastatin by 35% and 72%, respectively.

MANAGEMENT: Caution is recommended if osimertinib is used in combination with drugs that are substrates of the BCRP transporter, particularly those with a narrow therapeutic index. Monitoring for signs and symptoms of increased exposure to the BCRP substrate should be considered whenever osimertinib is added to or withdrawn from therapy.

Food prolongs the gastrointestinal absorption of selexipag. When taken with food, the time to peak concentration (Tmax) was delayed and peak plasma concentration (Cmax) was approximately 30% lower. Selexipag systemic exposure (AUC) and that of its active metabolite did not significantly change, however. Selexipag may be taken with or without food. Tolerability may be improved when taken with food.