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as well as clinical and laboratory monitoring may be appropriate for some drugs whenever selinexor is added to or withdrawn from therapy.

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.