Drug Interaction Report

MONITOR: Coadministration with niraparib may increase the plasma concentrations of drugs that are substrates of the breast cancer resistance protein (BCRP) transporter. The proposed mechanism is BCRP inhibition by niraparib. In vitro studies have shown that niraparib is able to inhibit BCRP, but a clinically meaningful interaction is unlikely.

MANAGEMENT: Caution is recommended if niraparib is used in combination with substrates of the breast cancer resistance protein (BCRP) transporter such as irinotecan, rosuvastatin, simvastatin, atorvastatin, and/or methotrexate. Monitoring for signs and symptoms of increased exposure to the BCRP substrate should be considered whenever niraparib is added to or withdrawn from therapy.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.