Cabozantinib with Posaconazole Interaction Details
Brand Names Associated with Cabozantinib
- Cabometyx®
- Cabozantinib
- Cometriq®
Brand Names Associated with Posaconazole
- Noxafil PowderMix®
- Noxafil®
- Posaconazole
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 22, 2023
Interaction Effect
Increased exposure of cabozantinib
Interaction Summary
Avoid coadministration of cabozantinib with a strong CYP3A4 inhibitor due to the potential for increased cabozantinib exposure and toxicity. If coadministration is required in patients with thyroid cancer, reduce the daily cabozantinib dosage by 40 mg . If coadministration is required in patients with renal or hepatocellular cancer, reduce the daily cabozantinib dosage by 20 mg . Upon discontinuation of the CYP3A4 inhibitor, wait 2 to 3 days before resuming the cabozantinib dosage used prior to initiation of the inhibitor .
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
Avoid coadministration of cabozantinib with a strong CYP3A4 inhibitor due to the potential for increased cabozantinib exposure and toxicity. If coadministration is required in patients with thyroid cancer, reduce the daily cabozantinib dosage by 40 mg (eg, from 140 mg to 100 mg daily). If coadministration is required in patients with renal or hepatocellular cancer, reduce the daily cabozantinib dosage by 20 mg (eg, from 60 mg to 40 mg daily) . Upon discontinuation of the CYP3A4 inhibitor, wait 2 to 3 days before resuming the cabozantinib dosage used prior to initiation of the inhibitor .
Mechanism Of Interaction
Inhibition of CYP3A4-mediated metabolism of cabozantinib
Literature Reports
A) In a pharmacokinetic study in 27 healthy subjects, the administration of a single dose of cabozantinib 140 mg (a CYP3A4 substrate) after 7 continuous daily doses of ketoconazole 400 mg (a strong CYP3A inhibitor) increased the cabozantinib AUC by 38% and the cabozantinib elimination half-life increased from 122 to 144 hours .
Cabozantinib Overview
-
Cabozantinib (Cabometyx, Cometriq) is used to treat a number of conditions.
-
Cabozantinib (Cabometyx) is used:
-
to treat advanced renal cell carcinoma (RCC; a type of cancer that begins in the cells of the kidneys).
-
in combination with nivolumab (Opdivo) to treat advanced RCC in patients who have not yet received a treatment for RCC.
-
to treat hepatocellular carcinoma (HCC; a type of liver cancer) in people who were previously treated with sorafenib (Nexafar).
-
to treat a certain type of thyroid cancer in adults and children 12 years of age and older that has spread to nearby tissues or to other parts of the body and that has not responded to previous a treatment and cannot be treated with radioactive iodine.
-
-
Cabozantinib (Cometriq) is used:
-
to treat a certain type of thyroid cancer that is getting worse and that has spread to other parts of the body.
-
-
Cabozantinib is in a class of medications called kinase inhibitors. It works by blocking the action of an abnormal protein that signals cancer cells to multiply. This helps slow or stop the spread of cancer cells.
Posaconazole Overview
-
Posaconazole is used to prevent serious fungal infections that can spread throughout the body in adults and children 2 years of age and older with a weakened ability to fight infection. Posaconazole delayed-release tablets are used to treat invasive aspergillosis (a serious fungal infection that begins in the lungs and spreads through the bloodstream to other organs) in adults and teenagers 13 years of age and older. Posaconazole oral suspension is also used to treat yeast infections of the mouth and throat including yeast infections in adults and teenagers 13 years of age and older that could not be treated successfully with other medications. Posaconazole is in a class of medications called azole antifungals. It works by slowing the growth of fungi that cause infection.
Return To Our Drug Interaction Homepage
Feedback, Question Or Comment About This Information?
Ask Dr. Brian Staiger, PharmD, our medical editor, directly! He's always more than happy to assist.
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.