Drug Interaction Report

GENERALLY AVOID: Coadministration with moderate inducers of CYP450 3A4 may decrease the plasma concentrations of fruquintinib, which is primarily metabolized by the isoenzyme. Concomitant use with efavirenz, a moderate CYP450 3A4 inducer, decreased fruquintinib peak plasma concentration (Cmax) and systemic exposure (AUC) by 4% and 32%, respectively. Reduced efficacy of fruquintinib may occur.

MANAGEMENT: Coadministration of fruquintinib with moderate CYP450 3A4 inducers should generally be avoided. The potential for diminished pharmacologic effects of fruquintinib should be considered during coadministration with moderate CYP450 3A4 inducers. However, if concomitant use is required, the manufacturer advises that fruquintinib may be continued at the recommended dosage.

ADJUST DOSING INTERVAL: Certain penicillins may exhibit reduced gastrointestinal absorption in the presence of food. The therapeutic effect of the antimicrobial may be reduced.

MANAGEMENT: The interacting penicillin should be administered one hour before or two hours after meals. Penicillin V and amoxicillin are not affected by food and may be given without regard to meals.