d the concomitant use of venetoclax and pioglitazone; venetoclax levels may be decreased and its efficacy reduced. Venetoclax is a CYP3A4 substrate and pioglitazone is a moderate CYP3A4 inducer. Consider alternative agents. In a drug interaction study (n = 11), the venetoclax Cmax and AUC values were decreased by 42% and 71%, respectively, following the co-administration of multiple doses of a strong CYP3A4 inducer. Use of venetoclax with a moderate CYP3A4 inducer has not been eva luated.
Metyrapone: Avoid the concomitant use of venetoclax and metyrapone; venetoclax levels may be decreased and its efficacy reduced. Venetoclax is a CYP3A4 substrate and metyrapone is a moderate CYP3A4 inducer. Consider alternative agents. In a drug interaction study (n = 11), the venetoclax Cmax and AUC values were decreased by 42% and 71%, respectively, following the co-administration of multiple doses of a strong CYP3A4 inducer. Use of venetoclax with a moderate CYP3A4 inducer has not been eva luated.
Mifepristone, RU-486: Avoid the concomitant use of venetoclax and mifepristone, RU-486; venetoclax is a substrate of CYP3A4 and P-glycoprotein (P-gp) and mifepristone is a CYP3A4 (in vitro) 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 mifepristone 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.
Mitotane: Avoid the concomitant use of venetoclax and mitotane; venetoclax levels may be significantly decreased and its efficacy reduced. Venetoclax is a CYP3A4 substrate and mitotane is a strong CYP3A4 inducer. Consider alternative agents. 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 multiple doses of a strong CYP3A4 inducer.
Modafinil: Avoid the concomitant use of venetoclax and modafinil; venetoclax levels may be decreased and its efficacy reduced. Venetoclax is a CYP3A4 substrate and modafinil is a moderate CYP3A4 inducer. Consider alternative agents. In a drug interaction study (n = 11), the venetoclax Cmax and AUC values were decreased by 42% and 71%, respectively, following the co-administration of multiple doses of a strong CYP3A4 inducer. Use of venetoclax with a moderate CYP3A4 inducer has not been eva luated.
Nafcillin: Avoid the concomitant use of venetoclax and nafcillin; venetoclax levels may be decreased and its efficacy reduced. Venetoclax is a CYP3A4 substrate and nafcillin is a moderate CYP3A4 inducer. Consider alternative agents. In a drug interaction study (n = 11), the venetoclax Cmax and AUC values were decreased by 42% and 71%, respectively, following the co-administration of multiple doses of a strong CYP3A4 inducer. Use of venetoclax with a moderate CYP3A4 inducer has not been eva luated.
Nefazodone: Avoid the concomitant use of venetoclax and nefazodone; venetoclax is a CYP3A4 substrate and nefazodone is a strong CYP3A4 inhibitor. The concomitant use of these agents together is contraindicated during the initial and dose titration phase of venetoc |
