Ceritinib with Vardenafil Interaction Details
Brand Names Associated with Ceritinib
- Ceritinib
- Zykadia®
Brand Names Associated with Vardenafil
- Levitra®
- Staxyn®
- Vardenafil
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 06, 2023
Interaction Effect
Increased vardenafil exposure, an increased risk of vardenafil adverse effects and an increased risk of QT interval prolongation
Interaction Summary
Concomitant use of ceritinib (a strong CYP3A inhibitor) and vardenafil (a CYP3A substrate) may increase exposure of the substrate. Coadministration with midazolam (a sensitive CYP3A substrate) has resulted in an increase in the midazolam AUC by 5.4-fold and Cmax by 1.8-fold. Use caution with concomitant use of ceritinib and vardenafil as this may increase vardenafil plasma concentrations, or may lead to additive effects on QT interval prolongation . Use of the orally disintegrating tablet formulation of vardenafil is not recommended with strong CYP3A4 inhibitors, such as ceritinib . If concomitant use of ceritinib and film-coated vardenafil tablets is indicated, use caution and consider dosage adjustment if necessary .
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
Concomitant use of ceritinib (a strong CYP3A inhibitor) and vardenafil (a CYP3A substrate) may increase exposure of the substrate. Use caution with concomitant use of ceritinib and vardenafil as this may increase vardenafil plasma concentrations, or may lead to additive effects on QT interval prolongation . Use of the orally disintegrating tablet formulation of vardenafil is not recommended with strong CYP3A4 inhibitors, such as ceritinib . If concomitant use of ceritinib and film-coated vardenafil tablets is indicated, use caution and consider dosage adjustment if necessary .
Mechanism Of Interaction
Inhibition of CYP3A4-mediated vardenafil metabolism by ceritinib; additive QT interval prolongation
Literature Reports
A) Coadministration of a single dose of midazolam (a sensitive CYP3A substrate) following 3 weeks of ceritinib 750 mg daily under fasted conditions increased the midazolam AUC by 5.4-fold and Cmax by 1.8-fold compared to midazolam administered alone .
B) In a single-dose, double-blind, randomized, placebo- and active-controlled crossover study, 59 male patients receiving vardenafil 10 mg (therapeutic), vardenafil 80 mg (supratherapeutic), or moxifloxacin 400 mg experienced similar increases in QTc interval measurements taken one hour after dosing. Single-dose administration resulted in a placebo-subtracted mean change from baseline QT (uncorrected) of 3 msec (90% confidence interval [CI]: 1, 5) for moxifloxacin 400 mg and -2 msec (90% CI: -4, 0) for both vardenafil 10 mg and 80 mg. Mean change from baseline Fridericia QT correction was 10 msec (90% CI: 8, 11) for vardenafil 80 mg, and 8 msec (90% CI: 6, 9) for both vardenafil 10 mg and moxifloxacin. Mean change from baseline for individual QT correction was 4 msec (90% CI: 3, 6) for vardenafil 10 mg, 6 msec (90% CI: 4, 7) for vardenafil 80 mg, and 7 msec (90% CI: 5, 8) for moxifloxacin. Mean increases in heart rate with vardenafil 10 mg and 80 mg were 5 and 6 beats per minute, respectively, compared with placebo .
C) In a pharmacokinetic study in healthy volunteers, coadministration of ketoconazole 200 mg daily with a single dose of vardenafil 5 mg resulted in a 4-fold increase in the vardenafil Cmax and a 10-fold increase in the vardenafil AUC compared with use of vardenafil alone .
Ceritinib Overview
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Ceritinib is used to treat a certain type of non-small cell lung cancer (NSCLC) that has spread to other parts of the body. Ceritinib 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.
Vardenafil Overview
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Vardenafil is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men. Vardenafil is in a class of medications called phosphodiesterase (PDE) inhibitors. It works by increasing blood flow to the penis during sexual stimulation. This increased blood flow can cause an erection. Vardenafil does not cure erectile dysfunction or increase sexual desire. Vardenafil does not prevent pregnancy or the spread of sexually transmitted diseases such as human immunodeficiency virus (HIV).
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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.