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Avatrombopag Maleate and Carbamazepine Extended-Release Capsules (Carbatrol)

Determining the interaction of Avatrombopag Maleate and Carbamazepine Extended-Release Capsules (Carbatrol) and the possibility of their joint administration.

Check result:
Avatrombopag Maleate <> Carbamazepine Extended-Release Capsules (Carbatrol)
Relevance: 05.11.2022 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:

Consumer information for this interaction is not currently available.ADJUST DOSE: Concomitant use of avatrombopag with moderate to potent dual inducers of CYP450 2C9 and 3A4 may decrease the systemic exposure (AUC) of avatrombopag which may lead to reduced efficacy. An open-label study evaluated the pharmacokinetic and pharmacodynamic drug-drug interactions of avatrombopag in combination with dual or selective CYP450 2C9 and 3A4 interacting drugs. Administration of a single 20 mg dose of avatrombopag to healthy subjects (n=48) who had achieved steady-state concentrations of rifampin (a moderate CYP450 2C9 and potent CYP450 3A4 inducer) resulted in a 0.57-fold decrease in avatrombopag AUC, and a shortened terminal elimination phase half-life from 20.3 hours to 9.84 hours. However, no impact on the maximum platelet count was observed. MANAGEMENT: For the treatment of patients with chronic immune thrombocytopenia, the manufacturer recommends an increased starting dose of avatrombopag 40 mg orally once daily when used concomitantly with a moderate to potent dual CYP450 2C9 and 3A4 inducer. In patients already receiving avatrombopag therapy and starting a moderate or strong dual CYP450 2C9 and 3A4 inducer, platelet counts should be monitored and avatrombopag dose adjusted according to the manufacturer's product labeling as necessary. Dose adjustments are not recommended when prescribed for the treatment of thrombocytopenia in adult patients with chronic liver disease undergoing a procedure. References Nomo, Zamora, Schuck, et al. "Pharmacokinetic/pharmacodynamic drug-drug interactions of avatrombopag when coadministered with dual or selective CYP2C9 and CYP3A interacting." PubMed 84 (2018): 1 "Product Information. Doptelet (avatrombopag)." Dova Pharmaceuticals, Durham, NC.

Professional:

ADJUST DOSE: Concomitant use of avatrombopag with moderate to potent dual inducers of CYP450 2C9 and 3A4 may decrease the systemic exposure (AUC) of avatrombopag which may lead to reduced efficacy. An open-label study evaluated the pharmacokinetic and pharmacodynamic drug-drug interactions of avatrombopag in combination with dual or selective CYP450 2C9 and 3A4 interacting drugs. Administration of a single 20 mg dose of avatrombopag to healthy subjects (n=48) who had achieved steady-state concentrations of rifampin (a moderate CYP450 2C9 and potent CYP450 3A4 inducer) resulted in a 0.57-fold decrease in avatrombopag AUC, and a shortened terminal elimination phase half-life from 20.3 hours to 9.84 hours. However, no impact on the maximum platelet count was observed.

MANAGEMENT: For the treatment of patients with chronic immune thrombocytopenia, the manufacturer recommends an increased starting dose of avatrombopag 40 mg orally once daily when used concomitantly with a moderate to potent dual CYP450 2C9 and 3A4 inducer. In patients already receiving avatrombopag therapy and starting a moderate or strong dual CYP450 2C9 and 3A4 inducer, platelet counts should be monitored and avatrombopag dose adjusted according to the manufacturer's product labeling as necessary. Dose adjustments are not recommended when prescribed for the treatment of thrombocytopenia in adult patients with chronic liver disease undergoing a procedure.

References
  • Nomo, Zamora, Schuck, et al. "Pharmacokinetic/pharmacodynamic drug-drug interactions of avatrombopag when coadministered with dual or selective CYP2C9 and CYP3A interacting." PubMed 84 (2018): 1
  • "Product Information. Doptelet (avatrombopag)." Dova Pharmaceuticals, Durham, NC.
Avatrombopag Maleate

Generic Name: avatrombopag

Brand name: Doptelet

Synonyms: n.a.

Carbamazepine Extended-Release Capsules (Carbatrol)

Generic Name: carbamazepine

Brand name: Carbatrol, Epitol, Equetro, Tegretol, Tegretol XR, Tegretol, Tegretol XR

Synonyms: Carbamazepine, CarBAMazepine

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.