nded 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.
Ketoconazole: Avoid the concomitant use of venetoclax and ketoconazole; the venetoclax Cmax and AUC values were significantly increased when ketoconazole was co-administered in a drug interaction study. 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 ketoconazole 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. Venetoclax is a substrate of CYP3A4, P-glycoprotein (P-gp), and Breast Cancer Resistance Protein (BCRP); ketoconazole is an inhibitor of CYP3A4 (strong), P-gp, and BCRP. In a drug interaction study (n = 11), the venetoclax Cmax increased 2.3-fold and the venetoclax AUC value increased 6.4-fold following the co-administration of ketoconazole 400 mg/day PO for 7 days in previously treated NHL patients.
Lansoprazole: Avoid the concomitant use of venetoclax and lansoprazole. Venetoclax is a substrate of P-glycoprotein (P-gp) and may be a P-gp inhibitor at therapeutic dose levels in the gut; lansoprazole is a substrate and an inhibitor of P-gp. 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) and consider administering lansoprazole at least 6 hours before venetoclax. If lansoprazole 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.
Lansoprazole; Naproxen: Avoid the concomitant use of venetoclax and lansoprazole. Venetoclax is a substrate of P-glycoprotein (P-gp) and may be a P-gp inhibitor at therapeutic dose levels in the gut; lansoprazole is a substrate and an inhibitor of P-gp. 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) and consider administering lansoprazole at least 6 hours before venetoclax. If lansoprazole 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.
Lapatinib: Avoid the concomitant use of venetoclax and lapatinib; venetoclax is a substrate of CYP3A4 and P-glycoprotein (P-gp) and lapatinib is a CYP3A |
