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Aprepitant Intravenous and Rubex

Determining the interaction of Aprepitant Intravenous and Rubex and the possibility of their joint administration.

Check result:
Aprepitant Intravenous <> Rubex
Relevance: 09.10.2022 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:

Aprepitant may increase the blood levels and effects of DOXOrubicin. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. 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:

MONITOR: Coadministration with aprepitant or its prodrug, fosaprepitant, may increase the plasma concentrations of chemotherapeutic agents that are primarily metabolized by CYP450 3A4. The proposed mechanism is decreased clearance due to inhibition of CYP450 3A4 activity by aprepitant. In premarketing clinical studies, aprepitant was administered commonly with etoposide, vinorelbine or paclitaxel, although dosages of these agents were not adjusted to account for potential drug interactions. In separate pharmacokinetic studies, aprepitant had no effect on the pharmacokinetics of docetaxel or vinorelbine, both of which are substrates of CYP450 3A4. However, an interaction has been demonstrated with the probe CYP450 3A4 substrate, midazolam. In general, the effect of aprepitant on the pharmacokinetics of CYP450 3A4 substrates is expected to be greater when the substrates are administered orally as opposed to intravenously and may be altered following prolonged administration.

MANAGEMENT: Caution is advised if aprepitant or fosaprepitant is administered with chemotherapeutic agents that are primarily metabolized by CYP450 3A4, particularly those that were not studied extensively in premarketing trials. The potential for increased systemic toxicities of these agents should be considered. Chronic, continuous use of aprepitant for prevention of nausea and vomiting is not recommended because it has not been studied and because the drug interaction profile may change during long-term use.

References
  • Charasson V, Haaz MC, Robert J "Determination of Drug Interactions Occurring with the Metabolic Pathways of Irinotecan." Drug Metab Dispos 30 (2002): 731-733
  • Zhou XJ, Zhou-Pan XR, Gauthier T, Placidi M, Maurel P, Rahmani R "Human liver microsomal cytochrome P450 3A isozymes mediated vindesine biotransformation. Metabolic drug interactions." Biochem Pharmacol 45 (1993): 853-61
  • "Product Information. Emend (aprepitant)." Merck & Company Inc, West Point, PA.
  • Clarke SJ, Rivory LP "Clinical pharmacokinetics of docetaxel." Clin Pharmacokinet 36 (1999): 99-114
  • "Product Information. Emend for Injection (fosaprepitant)." Merck & Company Inc, West Point, PA.
  • Kivisto KT, Kroemer HK, Eichelbaum M "The role of human cytochrome p450 enzymes in the metabolism of anticancer agents: implications for drug interactions." Br J Clin Pharmacol 40 (1995): 523-30
Aprepitant Intravenous

Generic Name: aprepitant

Brand name: Cinvanti, Emend, Emend 3-Day, Emend 2-Day

Synonyms: Aprepitant

Rubex

Generic Name: doxorubicin

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

Synonyms: Doxorubicin, DOXOrubicin (Conventional)

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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