Abiraterone Acetate with Oxycodone Interaction Details

Brand Names Associated with Abiraterone Acetate

Brand Names Associated with Oxycodone

Medical Content Editor Dr. Brian Staiger, PharmD
Last updated Feb 25, 2024

Interaction Effect

Increased oxyCODONE exposure

Interaction Summary

Abiraterone acetate is a strong CYP2D6 and moderate CYP3A4 inhibitor. In drug interaction studies, the AUC of dextromethorphan (a CYP2D6 substrate) was increased by 2.8-fold[1]. OxyCODONE is a major substrate of CYP3A4 and is in part metabolized to oxyMORphone via CYP2D6. Coadministration of the CYP3A4 inhibitor voriconazole with oxyCODONE resulted in a 3.6-fold increase in oxyCODONE AUC and a 1.7-fold increase in Cmax. Concomitant use of abiraterone acetate and oxyCODONE may result in prolonged or increased opioid effects. Monitor the patient frequently for respiratory depression or sedation. Consider dose adjustment of oxyCODONE until consistent effects are realized [2], and use caution during therapy and upon initiation and discontinuation [3][4][5].

Severity

Major

Onset

Unspecified

Evidence

Theoretical

How To Manage Interaction

Concomitant use of abiraterone acetate and oxyCODONE may result in prolonged or increased opioid effects. If such use is necessary, monitor the patient frequently for respiratory depression or sedation. Consider dose adjustment of oxyCODONE until consistent effects are realized[2], and use caution during therapy and upon initiation and discontinuation [3][4][5].

Mechanism Of Interaction

Inhibition of CYP3A4-mediated metabolism of oxyCODONE; inhibition of CYP2D6-mediated metabolism of oxyCODONE

References

1 ) Product Information: ZYTIGA(R) oral tablets, abiraterone acetate oral tablets. Janssen Biotech, Inc. (per FDA), Horsham, PA, 2013.

2 ) Product Information: XARTEMIS(TM) XR oral extended-release tablets, oxycodone HCl acetaminophen oral extended-release tablets. Mallinckrodt Brand Pharmaceuticals, Inc. (per FDA), Hazelwood, MO, 2015.

3 ) Product Information: OXAYDO(R) oral tablets, oxycodone HCl oral tablets. Zyla Life Sciences US Inc (per FDA), Wayne, PA, 2021.

4 ) Product Information: oxycodone HCl oral solution, oxycodone HCl oral solution. Lehigh Valley Technologies, Inc. (per DailyMed), Allentown, PA, 2013.

5 ) Product Information: OXYCONTIN(R) oral extended-release tablets, oxycodone HCl oral extended-release tablets. Purdue Pharma LP (per FDA), Stamford, CT, 2018.

Abiraterone Acetate Overview

• Abiraterone is used in combination with prednisone to treat a certain type of prostate cancer that has spread to other parts of the body. Abiraterone is in a class of medications called androgen biosynthesis inhibitors. It works by decreasing the amount of certain hormones in the body.

Oxycodone Overview

• Oxycodone is used to relieve moderate to severe pain. Oxycodone extended-release tablets and extended-release capsules are used to relieve severe pain in people who are expected to need pain medication around the clock for a long time and who cannot be treated with other medications. Oxycodone extended-release tablets and extended-release capsules should not be used to treat pain that can be controlled by medication that is taken as needed. Oxycodone extended-release tablets, extended-release capsules, and concentrated solution should only be used to treat people who are tolerant (used to the effects of the medication) to opioid medications because they have taken this type of medication for at least one week. Oxycodone is in a class of medications called opiate (narcotic) analgesics. It works by changing the way the brain and nervous system respond to pain.

• Oxycodone is also available in combination with acetaminophen (Oxycet, Percocet, Roxicet, Xartemis XR, others); aspirin (Percodan); and ibuprofen. This monograph only includes information about the use of oxycodone alone. If you are taking an oxycodone combination product, be sure to read information about all the ingredients in the product you are taking and ask your doctor or pharmacist for more information.

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.

Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.

Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.

Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.

Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.

Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.

How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.

Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.

Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

• Gold Standard Drug Database
• Micromedex
• Lexicomp
• DrugBank

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.