Adriamycin and Nexavar

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.

SORAfenib may increase the blood levels of DOXOrubicin. This may increase the risk and/or severity of side effects such as nausea, vomiting, diarrhea, mouth sores, heart problems, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to experience anemia, bleeding problems, or infections due to low blood cell counts. You should contact your doctor if you develop paleness, fatigue, dizziness, fainting, unusual bruising or bleeding, fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. Also seek immediate medical attention if you experience signs and symptoms that may suggest heart problems such as coughing, difficulty breathing, fluid retention, swelling, chest pain, and irregular heart rhythm. 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.

MONITOR: Coadministration with sorafenib may increase the plasma concentrations of doxorubicin. The mechanism of interaction has not been described, but may involve inhibition of P-glycoprotein efflux transporter by sorafenib. In a phase I study, concomitant use of doxorubicin (60 mg/m2 every 21 days) with sorafenib (400 mg twice daily, administered with a 3-day break in dosing around administration of doxorubicin) increased the mean peak plasma concentration (Cmax) of doxorubicin by 103% and systemic exposure (AUC) by 47%, but had no apparent impact on clinical toxicity such as myelosuppression or cardiotoxicity. No significant pharmacokinetic changes were observed in patients given lower dosages of sorafenib (100 mg or 200 mg twice daily), and sorafenib pharmacokinetics were not significantly altered by doxorubicin in the study. By contrast, a 21% increase in the AUC of doxorubicin has been cited in the sorafenib labeling.

MANAGEMENT: Caution may be advisable when doxorubicin is used with sorafenib. Patients should be monitored closely for potential toxicities of doxorubicin such as mucositis, myelosuppression and cardiotoxicity, and the dosage adjusted accordingly.

Adriamycin

Generic Name: doxorubicin

Brand name: Adriamycin, Adriamycin RDF, Rubex, Adriamycin PFS

Synonyms: n.a.

What is Adriamycin?

Nexavar

Generic Name: sorafenib

Brand name: Nexavar

Synonyms: n.a.

What is Nexavar?