Drug Interaction Report

GENERALLY AVOID: Coadministration with inducers of uridine diphosphoglucuronate-glucuronosyltransferase (UGT) enzymes and potent inducers of CYP450 3A4 isoenzymes may decrease the plasma concentrations of 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 3A4, strong CYP450 3A4 inducers can also induce UGT enzymes.

MANAGEMENT: According to the manufacturer, concomitant use of acoramidis with inducers of UGT enzymes and potent inducers of CYP450 3A4 should generally be avoided due to the potential for reduced efficacy.