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Evotaz and Onivyde

Determining the interaction of Evotaz and Onivyde and the possibility of their joint administration.

Check result:

Evotaz <> Onivyde

Relevance: 21.12.2022 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:

Using irinotecan liposomal together with atazanavir is not recommended. Studies have shown that atazanavir can interfere with the normal clearance of irinotecan liposomal 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. 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:

CONTRAINDICATED: Coadministration with atazanavir-ritonavir is predicted to significantly increase the plasma concentrations of irinotecan and its 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, coadministration of another potent CYP450 3A4 and UGT1A1 inhibitor, ketoconazole, resulted in a 100% increase in the relative exposure to SN-38 and an 87% reduction in the exposure to APC.

MANAGEMENT: Concomitant use of irinotecan with atazanavir-ritonavir or atazanavir-cobicistat is considered contraindicated by some authorities. Atazanavir-ritonavir should be discontinued for at least one week before initiation of treatment with irinotecan.

References

"Product Information. Onivyde (irinotecan liposomal)." Merrimack Pharmaceuticals, Cambridge, MA.
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. Reyataz (atazanavir)." Bristol-Myers Squibb, Princeton, NJ.
"Product Information. Camptosar (irinotecan)." Pharmacia and Upjohn, Kalamazoo, MI.
Canadian Pharmacists Association "e-CPS. Available from: URL: http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink."
Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

Evotaz

Generic Name: atazanavir / cobicistat

Brand name: Evotaz

Synonyms: n.a.

What is Evotaz?

Onivyde

Generic Name: irinotecan liposomal

Brand name: Onivyde

Synonyms: n.a.

What is Onivyde?

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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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