Drug Interaction Report

GENERALLY AVOID: The use of cladribine with medications that undergo intracellular phosphorylation may reduce its efficacy by inhibiting its phosphorylation to its active form. The clinical significance of this interaction is unknown.

MANAGEMENT: Concomitant use of cladribine with medications that undergo intracellular phosphorylation should be avoided if possible.

ADJUST DOSING INTERVAL: Oral cladribine may increase the bioavailability of other drugs, which may increase the risk or severity of adverse reactions. Cladribine tablets may contain hydroxypropyl betadex, which could form a complex with the active ingredients of other drugs, especially agents with low solubility. The clinical relevance of this interaction remains unknown.

MANAGEMENT: Administration of oral cladribine should be separated from any other oral drug by at least 3 hours.

ADJUST DOSING INTERVAL: Food delays the oral absorption and reduces the oral bioavailability of entecavir. According to the product labeling, administration of entecavir 0.5 mg with a standard high-fat meal or a light meal resulted in a delay in absorption by 0.25 to 0.75 hours, a decrease in the peak plasma concentration (Cmax) by 44% to 46%, and a decrease in the area under the plasma concentration-time curve (AUC) by 18% to 20% compared to administration in the fasting state.

MANAGEMENT: To ensure maximal oral absorption, entecavir should be administered on an empty stomach at least 2 hours after a meal and 2 hours before the next meal.