Drug Interaction Report

GENERALLY AVOID: Coadministration with brincidofovir may potentiate the toxicities of cidofovir. Brincidofovir is a lipid conjugate of cidofovir that is converted in vivo by intracellular phosphorylation to cidofovir diphosphate, thus concomitant administration may result in additive adverse effects, including diarrhea, neutropenia, hepatic impairment, and nephrotoxicity.

MANAGEMENT: Concurrent use of brincidofovir and cidofovir should be avoided

ADJUST DOSING INTERVAL: Administration with food decreases the oral bioavailability of brincidofovir. According to the product labeling, administration of brincidofovir tablets with a low-fat meal (approximately 400 calories, 25% of calories from fat) was associated with a reduction in the systemic exposure (AUC) and peak plasma concentration (Cmax) of brincidofovir by 31% and 49%, respectively, compared to administration under fasting. However, no clinically meaningful changes in intracellular concentrations of cidofovir diphosphate were observed. The effect of food on the oral suspension formulation has not been evaluated.

MANAGEMENT: Brincidofovir oral tablets and suspension should be taken on an empty stomach. If necessary, the oral tablets may be taken with a low-fat meal.

The recommended maximum number of medicines in the 'acyclovir-like antivirals' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'acyclovir-like antivirals' category:

• cidofovir
• Tembexa (brincidofovir)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.