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Dosage adjustments as well as clinical and laboratory monitoring should be considered whenever rucaparib is added to or withdrawn from therapy with these drugs.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.

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.