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Darunavir Tablets and Irinotecan Hydrochloride

Determining the interaction of Darunavir Tablets and Irinotecan Hydrochloride and the possibility of their joint administration.

Check result:
Darunavir Tablets <> Irinotecan Hydrochloride
Relevance: 17.05.2023 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:

Darunavir may interfere with the normal clearance of irinotecan from the body. This may increase side effects such as nausea, vomiting, abdominal pain, diarrhea (which can lead to dehydration and kidney failure if severe), mouth sores, lung or breathing 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. You should seek medical attention 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. Talk to your doctor if you have any questions or concerns. 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. 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 inhibitors of CYP450 3A4 and/or UGT1A1 may increase the plasma concentrations of irinotecan and its active metabolite, SN-38. CYP450 3A4 and UGT1A1 are the isoenzymes responsible for the metabolic conversion of irinotecan to its inactive metabolite, APC. Inhibition of APC formation results in more irinotecan metabolism to SN-38, an active and toxic metabolite. High plasma levels of irinotecan and SN-38 may increase the risk of potentially fatal toxicities such as severe diarrhea, neutropenia, sepsis, and thromboembolism. In cancer patients receiving irinotecan, coadministration of ketoconazole, a potent CYP450 3A4 and UGT1A1 inhibitor, resulted in a 100% increase in the relative exposure to SN-38 and an 87% reduction in the exposure to APC. In HIV patients with Kaposi's sarcoma, coadministration of irinotecan with lopinavir-ritonavir decreased the clearance of irinotecan by 47%, increased the AUC of SN-38 by 204%, and decreased the AUC of APC by 81%.

MANAGEMENT: Caution is advised when irinotecan is prescribed with CYP450 3A4 or UGT1A1 inhibitors. Patients should be monitored for toxicities such as diarrhea, myelosuppression, thromboembolism, and interstitial lung disease, and the irinotecan dosage adjusted accordingly or treatment discontinued as necessary.

References
  • Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  • Phansalker S, Desai AA, Bell D, et al "High-priority drug-drug interactions for use in electronic health records." J Am Med Inform Assoc 19 (2012): 735-43
  • Cerner Multum, Inc. "Australian Product Information." O 0
  • "Product Information. Onivyde (irinotecan liposomal)." Merrimack Pharmaceuticals, Cambridge, MA.
  • "Product Information. Camptosar (irinotecan)." Pharmacia and Upjohn, Kalamazoo, MI.
  • Corona G, Vaccher E, Sandron S, et al. "Lopinavir-ritonavir dramatically affects the pharmacokinetics of irinotecan in HIV patients with Kaposi's sarcoma." Clin Pharmacol Ther 83 (2008): 601-6
  • Canadian Pharmacists Association "e-CPS. Available from: URL: http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink."
Darunavir Tablets

Generic Name: darunavir

Brand name: Prezista

Synonyms: Darunavir

Irinotecan Hydrochloride

Generic Name: irinotecan

Brand name: Camptosar

Synonyms: Irinotecan (Conventional), Irinotecan

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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