e concomitant use of venetoclax and isavuconazonium; venetoclax is a substrate of CYP3A4 and P-glycoprotein (P-gp) and isavuconazonium is a CYP3A4 (moderate) and P-gp inhibitor. Consider alternative agents. If concomitant use of these drugs is required, reduce the venetoclax dosage by at least 50% (maximum dose of 200 mg/day). If isavuconazonium is discontinued, wait 2 to 3 days and then resume the recommended venetoclax dosage (or prior dosage if less). Monitor patients for signs and symptoms of venetoclax toxicity such as hematologic toxicity, GI toxicity, and tumor lysis syndrome. In a drug interaction study (n = 11), the venetoclax Cmax and AUC values were increased by 106% and 78%, respectively, when a P-gp inhibitor was co-administered in healthy subjects.
Isoniazid, INH; Pyrazinamide, PZA; Rifampin: Avoid the concomitant use of venetoclax and rifampin; venetoclax levels may be altered. Consider alternative agents. Venetoclax is a substrate of CYP3A4 and P-glycoprotein (P-gp) and rifampin is a strong inducer of CYP3A4 and an inhibitor of P-gp. In a drug interaction study in healthy subjects (n = 10), the venetoclax Cmax and AUC values were decreased by 42% and 71%, respectively, following the co-administration of rifampin 600 mg/day for 13 days. In another drug interaction study (n = 11), the venetoclax Cmax and AUC values were increased by 106% and 78%, respectively, when a single 600-mg dose of rifampin was co-administered in healthy subjects.
Isoniazid, INH; Rifampin: Avoid the concomitant use of venetoclax and rifampin; venetoclax levels may be altered. Consider alternative agents. Venetoclax is a substrate of CYP3A4 and P-glycoprotein (P-gp) and rifampin is a strong inducer of CYP3A4 and an inhibitor of P-gp. In a drug interaction study in healthy subjects (n = 10), the venetoclax Cmax and AUC values were decreased by 42% and 71%, respectively, following the co-administration of rifampin 600 mg/day for 13 days. In another drug interaction study (n = 11), the venetoclax Cmax and AUC values were increased by 106% and 78%, respectively, when a single 600-mg dose of rifampin was co-administered in healthy subjects.
Itraconazole: Avoid the concomitant use of venetoclax and itraconazole; venetoclax is a substrate of CYP3A4 and P-glycoprotein (P-gp) and itraconazole is a strong CYP3A4 and P-gp inhibitor. The concomitant use of these agents together is contraindicated during the initial and dose titration phase of venetoclax. If concomitant use of these drugs is required when the patient is on a steady venetoclax dose (after the titration phase), reduce the venetoclax dosage by at least 75% (maximum dose of 100 mg/day). If itraconazole is discontinued, wait 2 to 3 days and then resume the recommended venetoclax dosage (or prior dosage if less). Monitor patients for signs and symptoms of venetoclax toxicity such as hematologic toxicity, GI toxicity, and tumor lysis syndrome. In a drug interaction study, the venetoclax Cmax and AUC values were increased by 2.3-fold and 6.4-fold, respectively, when a strong CYP3A4 inhibitor was co-administered in NHL patients.
Ivacaftor: Avoid the concomitant use of venetoclax and ivacaftor. Venetoclax is a CYP3A4 and P-glycoprotein substrate and ivacaftor is a weak inhibitor of CYP3A and P-gp. Consider alternative agents. Consider alternative agents. If concomitant use of these drugs is required, reduce the venetoclax dosage by at least 50% (maximum dose of 200 mg/day). If ivacaftor is discontinued, wait 2 to 3 days and then resume the recomme |
