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Imbruvica (Ibrutinib Tablets) and Procardia XL

Determining the interaction of Imbruvica (Ibrutinib Tablets) and Procardia XL and the possibility of their joint administration.

Check result:
Imbruvica (Ibrutinib Tablets) <> Procardia XL
Relevance: 19.10.2022 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:

NIFEdipine may 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. You may need a dose adjustment or more frequent monitoring by your doctor 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.

Professional:

MONITOR: Coadministration with inhibitors of CYP450 3A4 may 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.

MANAGEMENT: Caution is advised if ibrutinib is prescribed in combination with CYP450 3A4 inhibitors. Patients should be closely monitored for signs of ibrutinib toxicity such as myelosuppression, bleeding, infection, and renal impairment. Dosage reduction in accordance with ibrutinib product labeling may be necessary if an interaction is suspected.

References
  • "Product Information. Imbruvica (ibrutinib)." Pharmacyclics Inc, Sunnyvale, CA.
Imbruvica (Ibrutinib Tablets)

Generic Name: ibrutinib

Brand name: Imbruvica

Synonyms: Imbruvica

Procardia XL

Generic Name: nifedipine

Brand name: Adalat CC, Procardia, Procardia XL, Afeditab CR, Nifediac CC, Nifedical XL, Adalat

Synonyms: n.a.

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.

Interaction with food and lifestyle