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Istradefylline and Mitoxantrone Injection Concentrate

Determining the interaction of Istradefylline and Mitoxantrone Injection Concentrate and the possibility of their joint administration.

Check result:
Istradefylline <> Mitoxantrone Injection Concentrate
Relevance: 20.06.2023 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:

Consumer information for this interaction is not currently available.MONITOR: Coadministration with inhibitors of P-glycoprotein (P-gp) may increase the plasma concentrations of mitoxantrone, which is a substrate of the efflux transporter also known as ABCB1 or MDR1. The interaction has been studied with cyclosporine, a potent P-gp inhibitor. In a pharmacokinetic study of 38 children with de novo acute myeloid leukemia, mitoxantrone 6 mg/m2 administered daily in combination with cyclosporine resulted in a 42% decrease in mean mitoxantrone clearance and 12% increase in systemic exposure (AUC) compared to mitoxantrone 10 mg/m2 administered daily without cyclosporine. There were no differences in the rates of stomatitis or infection between the two groups, but an increased incidence of hyperbilirubinemia was observed in the cyclosporine group, which rapidly reversed upon conclusion of treatment. Therefore, it appears a 40% dose reduction of mitoxantrone given with cyclosporine produced statistically similar systemic exposure and toxicity as mitoxantrone given alone. MANAGEMENT: Caution is advised if mitoxantrone is prescribed in combination with a P-gp inhibitor. Patients should be closely monitored for increased adverse effects including cardiotoxicity and myelosuppression. References "Multum Information Services, Inc. Expert Review Panel" "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.

Professional:

MONITOR: Coadministration with inhibitors of P-glycoprotein (P-gp) may increase the plasma concentrations of mitoxantrone, which is a substrate of the efflux transporter also known as ABCB1 or MDR1. The interaction has been studied with cyclosporine, a potent P-gp inhibitor. In a pharmacokinetic study of 38 children with de novo acute myeloid leukemia, mitoxantrone 6 mg/m2 administered daily in combination with cyclosporine resulted in a 42% decrease in mean mitoxantrone clearance and 12% increase in systemic exposure (AUC) compared to mitoxantrone 10 mg/m2 administered daily without cyclosporine. There were no differences in the rates of stomatitis or infection between the two groups, but an increased incidence of hyperbilirubinemia was observed in the cyclosporine group, which rapidly reversed upon conclusion of treatment. Therefore, it appears a 40% dose reduction of mitoxantrone given with cyclosporine produced statistically similar systemic exposure and toxicity as mitoxantrone given alone.

MANAGEMENT: Caution is advised if mitoxantrone is prescribed in combination with a P-gp inhibitor. Patients should be closely monitored for increased adverse effects including cardiotoxicity and myelosuppression.

References
  • "Multum Information Services, Inc. Expert Review Panel"
  • "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.
Istradefylline

Generic Name: istradefylline

Brand name: Nourianz

Synonyms: n.a.

Mitoxantrone Injection Concentrate

Generic Name: mitoxantrone

Brand name: Novantrone

Synonyms: Mitoxantrone, MitoXANtrone

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.