Darunavir Tablets and Ibrutinib

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.

Talk to your doctor before using ibrutinib together with darunavir. Combining these medications may significantly increase the blood levels of ibrutinib. This may increase the risk of side effects such as nausea, vomiting, diarrhea, abdominal pain, constipation, hemorrhage, kidney problems, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. 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 kidney damage such as nausea, vomiting, loss of appetite, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, shortness of breath, muscle cramps, tiredness, weakness, dizziness, confusion, 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.

ADJUST DOSE: Coadministration with moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of ibrutinib, which is primarily metabolized by the isoenzyme. In 18 healthy volunteers administered a single 120 mg dose of ibrutinib alone on day 1 and a single 40 mg dose of ibrutinib on day 7 in combination with ketoconazole 400 mg daily on days 4 thru 9, there was a 29-fold increase in dose-normalized ibrutinib peak plasma concentration (Cmax) and 24-fold increase in dose-normalized systemic exposure (AUC) during treatment with ketoconazole compared to administration alone. Pharmacokinetic modeling suggests that moderate CYP450 3A4 inhibitors such as diltiazem and erythromycin may increase the AUC of ibrutinib by 6- to 9-fold under fasting condition. The safety and efficacy of these exposures are unknown. The highest ibrutinib dose evaluated in clinical trials was 12.5 mg/kg (actual doses of 840 to 1400 mg) given for 28 days, which yielded single dose AUC values that were approximately 50% greater than steady-state exposures seen at the highest indicated dose of 560 mg.

MANAGEMENT: The dosage of ibrutinib should be adjusted according to the indication in the product labeling whenever it is used in combination with a moderate CYP450 3A4 inhibitor such as amprenavir, aprepitant, atazanavir, ciprofloxacin, crizotinib, darunavir, diltiazem, dronedarone, erythromycin, fluconazole, fosamprenavir, fosaprepitant, imatinib, or verapamil. All patients should be closely monitored for signs of ibrutinib toxicity such as myelosuppression, bleeding, infection, and renal impairment.

Darunavir Tablets

Generic Name: darunavir

Brand name: Prezista

Synonyms: Darunavir

What is Darunavir Tablets?

Ibrutinib

Generic Name: ibrutinib

Brand name: Imbruvica

Synonyms: n.a.

What is Ibrutinib?