Digoxin with Capmatinib Interaction Details

Brand Names Associated with Digoxin

Brand Names Associated with Capmatinib

Medical Content Editor Dr. Brian Staiger, PharmD
Last updated Jan 08, 2024

Interaction Effect

Risk of increased adverse reactions

Interaction Summary

Coadministration of capmatinib with a P-gp substrate increased P-gp substrate exposure, which may increase the adverse reactions of these substrates. When coadministered with digoxin (P-gp substrate), the AUC(0 to infinity) of digoxin increased by 47% and Cmax increased by 74% . If coadministration is unavoidable between capmatinib and P-gp substrates where minimal concentration changes may lead to serious adverse reactions, decrease the P-gp substrate dosage as recommended .

Severity

Major

Onset

Unspecified

Evidence

Theoretical

How To Manage Interaction

Coadministration of capmatinib with a P-gp substrate increased P-gp substrate exposure, which may increase the adverse reactions of these substrates. If coadministration is unavoidable between capmatinib and P-gp substrates where minimal concentration changes may lead to serious adverse reactions, decrease the P-gp substrate dosage as recommended.

Mechanism Of Interaction

Increased P-gp substrate exposure

Literature Reports

A) Coadministration of capmatinib with digoxin (a P-gp substrate) increased digoxin AUC(0 to infinity) by 47% and increased Cmax by 74% . Compared with digoxin alone, the digoxin geometric mean ratio for AUC(infinity) was 1.47 (90% CI, 1.28 to 1.68), AUC(last) was 1.63 (90% CI, 1.42 to 1.89), and Cmax was 1.74 (90% CI, 1.43 to 2.13) following coadministration of capmatinib and digoxin in a small prospective single-sequence study in adult patients with MET-dysregulated advanced solid tumors refractory to currently available therapies (N=32). Digoxin t(1/2) was also prolonged with coadministration of capmatinib compared with digoxin alone (61.4 vs 47 hours); Tmax was not affected. Capmatinib 400 mg twice daily for 12 days was coadministered with a single dose of digoxin 0.25 mg and rosuvastatin 10 mg on day 12 .

Digoxin Overview

• Digoxin is used to treat heart failure and abnormal heart rhythms (arrhythmias). It helps the heart work better and it helps control your heart rate.

Capmatinib Overview

• Capmatinib is used to treat a certain type of non-small cell lung cancer (NSCLC) that has spread to other parts of the body. Capmatinib 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.

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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.