Drug Interaction Report

ADJUST DOSE: Coadministration with inhibitors of organic anion transporting polypeptide (OATP) 1B1 and/or 1B3 may significantly increase the plasma concentrations of atogepant, which is a substrate of the hepatic uptake transporters. When atogepant was administered in healthy study subjects with single-dose rifampin, an OATP 1B1/1B3 inhibitor, atogepant peak plasma concentration (Cmax) and systemic exposure (AUC) increased by approximately 2.2- and 2.9-fold, respectively.

MANAGEMENT: The recommended dosage of atogepant is 10 mg or 30 mg once daily when used concomitantly with OATP 1B1/1B3 inhibitors.

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of pazopanib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. Although not studied, the interaction may increase the risk of QT interval prolongation and torsade de pointes arrhythmia as well as severe and fatal hepatotoxicity associated with the use of pazopanib.

ADJUST DOSING INTERVAL: Food increases the oral bioavailability of pazopanib. The mechanism of interaction is unknown. Administration of pazopanib with a high-fat or low-fat meal results in an approximately 2-fold increase in peak plasma concentration (Cmax) and systemic exposure (AUC).

MANAGEMENT: Patients treated with pazopanib should avoid consumption of grapefruit, grapefruit juice, and any supplement containing grapefruit extract. Pazopanib should be administered at least one hour before or two hours after a meal.