Atazanavir with Sonidegib Interaction Details
Brand Names Associated with Atazanavir
- Atazanavir
- ATZ
- Reyataz®
Brand Names Associated with Sonidegib
- Odomzo®
- Sonidegib
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Feb 29, 2024
Interaction Effect
Increased sonidegib exposure
Interaction Summary
The concomitant use of sonidegib, a CYP3A substrate, with a moderate CYP3A inhibitor may result in increased sonidegib exposure and increase the risk of adverse effects[1]. Based on projections from coadministration of sonidegib with ketoconazole, a strong CYP3A inhibitor, the AUC of sonidegib would increase 1.79-fold if sonidegib 200 mg once daily is coadministered with a moderate CYP3A inhibitor for 14 days and a 2.79-fold increase if coadministered for 4 months [2]. Therefore, it is recommended that coadministration of sonidegib with a moderate CYP3A inhibitor be avoided. If coadministration cannot be avoided, concurrent use should be limited to less than 14 days and patients should be monitored closely for adverse reactions particularly musculoskeletal toxicity [1].
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
The concurrent use of sonidegib, a CYP3A substrate, with a moderate CYP3A inhibitor may result in increased sonidegib exposure and increase the risk of adverse effects. Avoid concomitant use of sonidegib with moderate CYP3A inhibitors. If coadministration cannot be avoided, limit concurrent use to less than 14 days and monitor closely for adverse reactions particularly musculoskeletal toxicity[1].
Mechanism Of Interaction
Inhibition of CYP3A4-mediated metabolism of sonidegib
Literature Reports
A) In a pharmacokinetic study of 31 healthy volunteers, the mean AUC(0 to 10 days) increased 2.25-fold and the Cmax increased 1.49-fold with sonidegib 800 mg single-dose administered 5 days after initiating oral ketoconazole (a strong CYP3A inhibitor) 200 mg twice daily, compared with a single dose of sonidegib alone. Based on pharmacokinetic modeling projections, the mean AUC(0 to 24 hours) and Cmax of sonidegib would increase 1.79-fold and 1.64-fold, respectively, if sonidegib 200 mg once daily is coadministered to cancer patients with erythromycin (a moderate CYP3A inhibitor) for 14 days, and 2.79-fold and 2.43-fold, respectively, if coadministered for 4 months [2].
References
1 ) Product Information: ODOMZO(R) oral capsules, sonidegib oral capsules. Novartis Pharmaceuticals (per FDA), East Hanover, NJ, 2015.
2 ) Einolf HJ, Zhou J, Won C, et al: A physiologically-based pharmacokinetic modeling approach to predict drug-drug interactions of sonidegib (LDE225) with perpetrators of CYP3A in cancer patients. Drug Metab Dispos 2017; 45(4):361-374.PubMed Abstract: http://www.ncbi.nlm.nih.gov/...
Atazanavir Overview
-
Atazanavir is used along with other medications to treat human immunodeficiency virus (HIV) infection in adults and children who are at least 3 months of age and weigh at least 22 lb (10 kg). Atazanavir is in a class of medications called protease inhibitors. It works by decreasing the amount of HIV in the blood. Although atazanavir does not cure HIV, it may decrease your chance of developing acquired immunodeficiency syndrome (AIDS) and HIV-related illnesses such as serious infections or cancer. Atazanavir must be given with other medications that treat HIV infection to completely treat the infection. Taking these medications along with practicing safer sex and making other lifestyle changes may decrease the risk of transmitting the HIV virus to other people.
Sonidegib Overview
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Sonidegib is used to treat basal cell carcinoma (BCC; a type of skin cancer) in adults with cancer that has come back after surgery or radiation, or in adults that cannot be treated with surgery or radiation. Sonidegib is in a class of medications called hedgehog pathway inhibitors. It works by blocking the action of a protein that signals cancer cells to multiply. This helps stop or slow the spread of cancer cells and may help shrink tumors.
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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:
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.