Drug Interaction Report

GENERALLY AVOID: According to the manufacturer, coadministration with inducers of uridine diphosphoglucuronate-glucuronosyltransferase (UGT) enzymes and potent inducers of CYP450 3A isoenzymes can potentially decrease exposure to acoramidis. In vitro, acoramidis is a substrate of multiple UGT enzymes including UGT1A9, UGT1A1, and UGT2B7 and is primarily metabolized by UGT enzyme-mediated glucuronidation. Acoramidis beta-D-glucuronide (Acoramidis-AG) is the predominant metabolite of acoramidis. Acoramidis-AG is approximately 1/3 as pharmacologically active compared with acoramidis, has a low potential for covalent binding, and does not contribute to pharmacological activity. While acoramidis is not metabolized by CYP450 3A, potent inducers of CYP450 3A can also induce UGT enzymes.

MANAGEMENT: Concomitant use of acoramidis with inducers of UGT enzymes and potent inducers of CYP450 3A should be avoided.