drugs is required, reduce the venetoclax dosage by at least 50% (maximum dose of 200 mg/day). If paliperidone 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.
Pantoprazole: Avoid the concomitant use of venetoclax and pantoprazole. Venetoclax is a substrate of P-glycoprotein (P-gp) and may be a P-gp inhibitor at therapeutic dose levels in the gut; pantoprazole 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 pantoprazole at least 6 hours before venetoclax. If pantoprazole 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.
Phenobarbital: Avoid the concomitant use of venetoclax and phenobarbital; venetoclax levels may be significantly decreased and its efficacy reduced. Venetoclax is a CYP3A4 and P-glycoprotein (P-gp) substrate and phenobarbital is a strong CYP3A4 inducer and a P-gp 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.
Phenytoin: Avoid the concomitant use of venetoclax and phenytoin or fosphenytoin; venetoclax levels may be significantly decreased and its efficacy reduced. Venetoclax is a CYP3A4 substrate and phenytoin 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.
Pioglitazone: Avoid 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.
Posaconazole: Avoid the concomitant use of venetoclax and posaconazole; venetoclax is a substrate of CYP3A4 and P-glycoprotein (P-gp) and posaconazole 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 posaconazole is discontinued, wait 2 to 3 days and then resume the r |
