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Abemaciclib and Zykadia

Determining the interaction of Abemaciclib and Zykadia and the possibility of their joint administration.

Check result:
Abemaciclib <> Zykadia
Relevance: 01.11.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Consumer information for this interaction is not currently available.ADJUST DOSE: Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of abemaciclib and its pharmacologically active metabolites, all of which are substrates of the isoenzyme. According to the product labeling, abemaciclib systemic exposure (AUC) is predicted to increase by up to 16-fold when administered with the potent CYP450 3A4 inhibitor ketoconazole, thus concomitant use is not recommended. Itraconazole, another potent inhibitor, is predicted to increase the relative potency-adjusted unbound AUC of abemaciclib plus its active metabolites by 2.2-fold. In cancer patients, administration of a single 50 mg dose of abemaciclib (one-third the approved recommended dose of 150 mg) with clarithromycin 500 mg twice daily increased the relative potency-adjusted unbound AUC of abemaciclib plus its active metabolites by 1.7-fold relative to abemaciclib administered alone. MANAGEMENT: When used with potent CYP450 3A4 inhibitors other than ketoconazole (which is not recommended), patients who would otherwise be on abemaciclib 200 mg or 150 mg twice daily should have their dosage reduced to 100 mg twice daily. In patients who have already had a dosage reduction to 100 mg twice daily due to adverse reactions, a further reduction of the abemaciclib dosage to 50 mg twice daily is recommended. Following discontinuation of the potent CYP450 3A4 inhibitor, abemaciclib dosage should be increased (after 3 to 5 half-lives of the inhibitor) to the dosage that was used before starting the inhibitor. References "Product Information. Verzenio (abemaciclib)." Lilly, Eli and Company, Indianapolis, IN.

Professional:

ADJUST DOSE: Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of abemaciclib and its pharmacologically active metabolites, all of which are substrates of the isoenzyme. According to the product labeling, abemaciclib systemic exposure (AUC) is predicted to increase by up to 16-fold when administered with the potent CYP450 3A4 inhibitor ketoconazole, thus concomitant use is not recommended. Itraconazole, another potent inhibitor, is predicted to increase the relative potency-adjusted unbound AUC of abemaciclib plus its active metabolites by 2.2-fold. In cancer patients, administration of a single 50 mg dose of abemaciclib (one-third the approved recommended dose of 150 mg) with clarithromycin 500 mg twice daily increased the relative potency-adjusted unbound AUC of abemaciclib plus its active metabolites by 1.7-fold relative to abemaciclib administered alone.

MANAGEMENT: When used with potent CYP450 3A4 inhibitors other than ketoconazole (which is not recommended), patients who would otherwise be on abemaciclib 200 mg or 150 mg twice daily should have their dosage reduced to 100 mg twice daily. In patients who have already had a dosage reduction to 100 mg twice daily due to adverse reactions, a further reduction of the abemaciclib dosage to 50 mg twice daily is recommended. Following discontinuation of the potent CYP450 3A4 inhibitor, abemaciclib dosage should be increased (after 3 to 5 half-lives of the inhibitor) to the dosage that was used before starting the inhibitor.

References
  • "Product Information. Verzenio (abemaciclib)." Lilly, Eli and Company, Indianapolis, IN.
Abemaciclib

Generic Name: abemaciclib

Brand name: Verzenio

Synonyms: n.a.

Zykadia

Generic Name: ceritinib

Brand name: Zykadia

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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