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Dabrafenib and PCE Dispertab

Determining the interaction of Dabrafenib and PCE Dispertab and the possibility of their joint administration.

Check result:
Dabrafenib <> PCE Dispertab
Relevance: 17.09.2022 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:

Erythromycin may increase the blood levels and effects of dabrafenib. 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 such as headache, fever, vision changes, eye pain, and skin lesions. 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 potent inhibitors of CYP450 3A4 and/or 2C8 may increase the plasma concentrations of dabrafenib and its active metabolites. In vitro studies have shown that dabrafenib is a substrate of CYP450 3A4 and 2C8, while hydroxy-dabrafenib and desmethyl-dabrafenib are substrates of CYP450 3A4. In a pharmacokinetic study, administration of dabrafenib 75 mg twice daily in combination with the potent CYP450 3A4 inhibitor ketoconazole 400 mg once daily for 4 days increased dabrafenib systemic exposure (AUC) by 71%, hydroxy-dabrafenib AUC by 82%, and desmethyl-dabrafenib AUC by 68%. When dabrafenib was given similarly with the potent CYP450 2C8 inhibitor gemfibrozil 600 mg twice daily for 4 days, dabrafenib AUC increased by 47%, but AUC of the metabolites did not change.

MONITOR: Coadministration with dabrafenib may decrease the plasma concentrations of drugs that are substrates of CYP450 3A4, including many of the known inhibitors of the isoenzyme such as conivaptan, delavirdine, nefazodone, telithromycin, and most azole antifungal agents, macrolide antibiotics, and protease inhibitors. Dabrafenib has been found in vitro to be a dose-dependent inducer of CYP450 3A4. Onset of induction is likely to occur after 3 days of repeat dosing with dabrafenib; however, transient inhibition of CYP450 3A4 may be observed during the first few days of treatment. In 12 study subjects, administration of the CYP450 3A4 probe substrate midazolam following repeat doses of dabrafenib 150 mg twice daily for 15 days reduced midazolam peak plasma concentration (Cmax) by 61% and systemic exposure (AUC) by 74%.

MANAGEMENT: The use of dabrafenib with potent CYP450 2C8 inhibitors such as gemfibrozil or potent CYP450 3A4 inhibitors such as ceritinib, clarithromycin, cobicistat, conivaptan, delavirdine, erythromycin, idelalisib, nefazodone, telithromycin, and most protease inhibitors and azole antifungal agents should generally be avoided if possible. Otherwise, patients should be closely monitored for development of adverse effects such as febrile reactions (high fever or fever accompanied by rigors, hypotension, dehydration, or renal failure), hyperglycemia, uveitis, and cutaneous malignancies (e.g., squamous cell carcinoma, keratoacanthoma, melanoma). During coadministration of dabrafenib with a CYP450 3A4 inhibitor, the potential for diminished therapeutic effects of the inhibitor should also be considered.

References
  • "Product Information. Tafinlar (dabrafenib)." GlaxoSmithKline, Research Triangle Park, NC.
Dabrafenib

Generic Name: dabrafenib

Brand name: Tafinlar

Synonyms: n.a.

PCE Dispertab

Generic Name: erythromycin

Brand name: EES. Granules, EES-400 Filmtab, EryPed 200, EryPed 400, Ery-Tab, Erythrocin Lactobionate, Erythrocin Stearate Filmtab, PCE Dispertab, E. E. S, EryPed, Erythrocin, Erythromycin Filmtabs, Erythromycin Lactobionate - IV

Synonyms: PCE Dispertab (Oral), PCE, PCE (Oral)

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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