Drug Interaction Report

MONITOR: Coadministration with selinexor may increase the plasma concentrations of drugs that are substrates of the organic anion transporting polypeptide (OATP) 1B3. The proposed mechanism, based on in vitro studies, is decreased clearance due to inhibition of OATP1B3 by selinexor. The clinical relevance of this interaction is unknown.

MANAGEMENT: Caution is advised if selinexor is used concomitantly with drugs that are substrates of OATP1B3, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever selinexor is added to or withdrawn from therapy.

ADJUST DOSING INTERVAL: Food enhances the oral bioavailability of glecaprevir and pibrentasvir. Relative to fasting conditions, mean glecaprevir systemic exposure (AUC) increased by 83% to 163% and mean pibrentasvir AUC increased by 40% to 53% when administered with moderate to high fat meals.

MANAGEMENT: Glecaprevir-pibrentasvir should be administered with food.