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Ado-trastuzumab emtansine and Kaletra Oral Solution

Determining the interaction of Ado-trastuzumab emtansine and Kaletra Oral Solution and the possibility of their joint administration.

Check result:
Ado-trastuzumab emtansine <> Kaletra Oral Solution
Relevance: 19.08.2022 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:

Talk to your doctor before using ado-trastuzumab emtansine together with ritonavir. Combining these medications may increase the blood levels and effects of ado-trastuzumab emtansine. This may increase the risk of potentially serious side effects such as liver impairment, heart failure, nerve damage, and bleeding problems. You may not be able to take ado-trastuzumab emtansine during treatment with ritonavir, or you may need a dose adjustment and/or more frequent monitoring by your doctor to safely use both medications. Your doctor may also be able to prescribe alternatives that do not interact. You should contact your doctor if you experience shortness of breath, coughing, swelling of the legs or ankles, sudden weight gain (for example, more than 5 pounds in 24 hours), palpitations, dizziness or loss of consciousness, as these may be early symptoms of heart failure. You should also seek immediate medical attention if you develop signs and symptoms of liver damage such as fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, light colored stools, and yellowing of the skin or eyes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

GENERALLY AVOID: Coadministration with inhibitors of CYP450 3A4 may increase exposure to the cytotoxic component of ado-trastuzumab emtansine known as DM1, which has been shown in vitro to be primarily metabolized by CYP450 3A4 and to a lesser extent by CYP450 3A5. No formal drug interaction studies have been conducted. Theoretically, the risk of toxicity may be increased.

MANAGEMENT: The use of ado-trastuzumab emtansine in combination with potent CYP450 3A4 inhibitors such as itraconazole, ketoconazole, posaconazole, voriconazole, conivaptan, nefazodone, cobicistat, delavirdine, protease inhibitors, and ketolide and certain macrolide antibiotics should generally be avoided. Alternative agents with no or minimal CYP450 3A4 inhibitory potential are recommended whenever possible. If no alternatives exist, consider delaying initiation of ado-trastuzumab emtansine until therapy with the potent CYP450 3A4 inhibitor is complete and the drug has cleared from the circulation, or approximately 3 elimination half-lives. When concomitant administration is necessary, patients should be closely monitored for adverse reactions such as hepatic impairment, left ventricular dysfunction, peripheral neuropathy, and thrombocytopenia.

References
  • "Product Information. Kadcyla (ado-trastuzumab)." Genentech, South San Francisco, CA.
Ado-trastuzumab emtansine

Generic Name: ado-trastuzumab emtansine

Brand name: Kadcyla

Synonyms: Ado-Trastuzumab Emtansine

Kaletra Oral Solution

Generic Name: lopinavir / ritonavir

Brand name: Kaletra

Synonyms: Kaletra

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.