Brexpiprazole and Zykadia

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 information for this interaction is not currently available.ADJUST DOSE: Coadministration with inhibitors of CYP450 3A4 and/or 2D6 may significantly increase the plasma concentrations of brexpiprazole, which is metabolized by these isoenzymes. According to product labeling, administration of brexpiprazole with a potent 3A4 inhibitor (ketoconazole) or a potent 2D6 inhibitor (quinidine) resulted in an approximately 2-fold increase in AUC. The combination of brexpiprazole plus potent CYP450 3A4 inhibitors in poor 2D6 metabolizers is expected to result in a 4.8-fold increase in AUC. The combination of brexpiprazole plus potent CYP450 3A4 inhibitors plus potent CYP450 2D6 inhibitors in extensive 2D6 metabolizers is expected to result in a 5.1 increase in AUC. MANAGEMENT: The manufacturer recommends that the brexpiprazole dosage be reduced as follows during concomitant administration of CYP450 inhibitors. The brexpiprazole dosage should be increased to the original level if these agents are discontinued. It is advisable to monitor patients for clinical response. - Potent 3A4 inhibitor: One-half of the usual dose. - Potent or moderate 3A4 inhibitor in known poor 2D6 metabolizers: One-fourth of the usual dose. - Potent 2D6 inhibitor: One-half of the usual dose. No dosage adjustments are required for patients with major depressive disorder. - Potent or moderate 3A4 inhibitor plus potent or moderate 2D6 inhibitor: One-fourth of the usual dose. Potent CYP450 3A4 inhibitors: antiviral boosters, boceprevir, ceritinib, clarithromycin, conivaptan, delavirdine, idelalisib, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, posaconazole, saquinavir, telaprevir, telithromycin, voriconazole. Moderate CYP450 3A4 inhibitors: aprepitant, atazanavir, ciprofloxacin, clotrimazole, crizotinib, dalfopristin, darunavir, diltiazem, dronedarone, erythromycin, fluconazole, fosamprenavir, fosaprepitant, imatinib, isavuconazonium, mifepristone, netupitant, nilotinib, ranolazine, stiripentol, verapamil. Potent CYP450 2D6 inhibitors: bupropion, cinacalcet, fluoxetine, methotrimeprazine, paroxetine, quinidine, ritonavir. Moderate CYP450 2D6 inhibitors: abiraterone, celecoxib, cimetidine, clobazam, darifenacin, diphenhydramine, duloxetine, eliglustat, lorcaserin, mirabegron, panobinostat, ranolazine, sertraline, stiripentol. References "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc, Rockville, MD.

ADJUST DOSE: Coadministration with inhibitors of CYP450 3A4 and/or 2D6 may significantly increase the plasma concentrations of brexpiprazole, which is metabolized by these isoenzymes. According to product labeling, administration of brexpiprazole with a potent 3A4 inhibitor (ketoconazole) or a potent 2D6 inhibitor (quinidine) resulted in an approximately 2-fold increase in AUC.
The combination of brexpiprazole plus potent CYP450 3A4 inhibitors in poor 2D6 metabolizers is expected to result in a 4.8-fold increase in AUC. The combination of brexpiprazole plus potent CYP450 3A4 inhibitors plus potent CYP450 2D6 inhibitors in extensive 2D6 metabolizers is expected to result in a 5.1 increase in AUC.

MANAGEMENT: The manufacturer recommends that the brexpiprazole dosage be reduced as follows during concomitant administration of CYP450 inhibitors. The brexpiprazole dosage should be increased to the original level if these agents are discontinued. It is advisable to monitor patients for clinical response.

- Potent 3A4 inhibitor: One-half of the usual dose.
- Potent or moderate 3A4 inhibitor in known poor 2D6 metabolizers: One-fourth of the usual dose.
- Potent 2D6 inhibitor: One-half of the usual dose. No dosage adjustments are required for patients with major depressive disorder.
- Potent or moderate 3A4 inhibitor plus potent or moderate 2D6 inhibitor: One-fourth of the usual dose.

Potent CYP450 3A4 inhibitors: antiviral boosters, boceprevir, ceritinib, clarithromycin, conivaptan, delavirdine, idelalisib, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, posaconazole, saquinavir, telaprevir, telithromycin, voriconazole.

Moderate CYP450 3A4 inhibitors: aprepitant, atazanavir, ciprofloxacin, clotrimazole, crizotinib, dalfopristin, darunavir, diltiazem, dronedarone, erythromycin, fluconazole, fosamprenavir, fosaprepitant, imatinib, isavuconazonium, mifepristone, netupitant, nilotinib, ranolazine, stiripentol, verapamil.

Potent CYP450 2D6 inhibitors: bupropion, cinacalcet, fluoxetine, methotrimeprazine, paroxetine, quinidine, ritonavir.

Moderate CYP450 2D6 inhibitors: abiraterone, celecoxib, cimetidine, clobazam, darifenacin, diphenhydramine, duloxetine, eliglustat, lorcaserin, mirabegron, panobinostat, ranolazine, sertraline, stiripentol.

Brexpiprazole

Generic Name: brexpiprazole

Brand name: Rexulti

Synonyms: n.a.

What is Brexpiprazole?

Zykadia

Generic Name: ceritinib

Brand name: Zykadia

Synonyms: n.a.

What is Zykadia?