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Tibsovo and Zykadia

Determining the interaction of Tibsovo and Zykadia and the possibility of their joint administration.

Check result:
Tibsovo <> Zykadia
Relevance: 16.09.2022 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:

Consumer information for this interaction is not currently available.GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of ivosidenib, which is primarily metabolized by the isoenzyme. When a single 250 mg dose of ivosidenib was administered with the potent CYP450 3A4 inhibitor itraconazole (200 mg once daily for 18 days), ivosidenib systemic exposure (AUC) increased to 269% of control, with no change in peak plasma concentration (Cmax). Increased exposure to ivosidenib may increase the risk of QT interval prolongation, which has been associated with ventricular arrhythmias including torsade de pointes and sudden death. GENERALLY AVOID: Coadministration with ivosidenib may decrease the plasma concentrations of drugs that are primarily metabolized by CYP450 3A4, including many of the known potent inhibitors of the isoenzyme such as clarithromycin, conivaptan, delavirdine, idelalisib, itraconazole, ketoconazole, nefazodone, posaconazole, telithromycin, and all protease inhibitors. Ivosidenib is an inducer of CYP450 3A4 and induces its own metabolism following multiple dosing. MANAGEMENT: Concomitant use of ivosidenib with potent CYP450 3A4 inhibitors, particularly those that are also substrates of CYP450 3A4, should generally be avoided. If coadministration is required, a reduction of the ivosidenib dosage to 250 mg once daily is recommended. Following discontinuation of the potent inhibitor for at least 5 half-lives, ivosidenib therapy should be returned to the recommended dosage of 500 mg once daily. Monitoring of electrocardiograms and electrolytes should be conducted regularly. References "Product Information. Tibsovo (ivosidenib)." Agios Pharmaceuticals, Cambridge, MA.

Professional:

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of ivosidenib, which is primarily metabolized by the isoenzyme. When a single 250 mg dose of ivosidenib was administered with the potent CYP450 3A4 inhibitor itraconazole (200 mg once daily for 18 days), ivosidenib systemic exposure (AUC) increased to 269% of control, with no change in peak plasma concentration (Cmax). Increased exposure to ivosidenib may increase the risk of QT interval prolongation, which has been associated with ventricular arrhythmias including torsade de pointes and sudden death.

GENERALLY AVOID: Coadministration with ivosidenib may decrease the plasma concentrations of drugs that are primarily metabolized by CYP450 3A4, including many of the known potent inhibitors of the isoenzyme such as clarithromycin, conivaptan, delavirdine, idelalisib, itraconazole, ketoconazole, nefazodone, posaconazole, telithromycin, and all protease inhibitors. Ivosidenib is an inducer of CYP450 3A4 and induces its own metabolism following multiple dosing.

MANAGEMENT: Concomitant use of ivosidenib with potent CYP450 3A4 inhibitors, particularly those that are also substrates of CYP450 3A4, should generally be avoided. If coadministration is required, a reduction of the ivosidenib dosage to 250 mg once daily is recommended. Following discontinuation of the potent inhibitor for at least 5 half-lives, ivosidenib therapy should be returned to the recommended dosage of 500 mg once daily. Monitoring of electrocardiograms and electrolytes should be conducted regularly.

References
  • "Product Information. Tibsovo (ivosidenib)." Agios Pharmaceuticals, Cambridge, MA.
Tibsovo

Generic Name: ivosidenib

Brand name: Tibsovo

Synonyms: n.a.

Zykadia

Generic Name: ceritinib

Brand name: Zykadia

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.

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