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.
Atorvastatin; Ezetimibe: Avoid the concomitant use of venetoclax and atorvastatin. Venetoclax is a substrate of P-glycoprotein (P-gp) and may be a P-gp inhibitor at therapeutic dose levels in the gut; atorvastatin 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 atorvastatin at least 6 hours before venetoclax. If atorvastatin 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.
Atropine; Hyoscyamine; Phenobarbital; Scopolamine: 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.
Azithromycin: Avoid the concomitant use of venetoclax and azithromycin; venetoclax is a substrate of P-glycoprotein (P-gp) and azithromycin is 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). If azithromycin 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.
Belladonna Alkaloids; Ergotamine; 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.
Bexarotene: Avoid the concomitant use of venetoclax and bexarotene; venetoclax levels may be decreased and its efficacy reduced. Venetoclax is a CYP3A4 substrate and bexarotene 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 ind |
