Duvelisib with Lorlatinib Interaction Details
Brand Names Associated with Duvelisib
- Copiktra®
- Duvelisib
Brand Names Associated with Lorlatinib
- Lorbrena®
- Lorlatinib
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 28, 2023
Interaction Effect
Decreased duvelisib exposure
Interaction Summary
Concomitant use of duvelisib (CYP3A4 substrate) with a moderate CYP3A4 inducer decreases duvelisib exposure, which may decrease duvelisib efficacy. Coadministration of a single dose of duvelisib in healthy subjects reviewing etravirine increased duvelisib Cmax and AUC by 16% and 35%, respectively. Avoid concomitant use of duvelisib and a moderate CP3A4 inducer. If coadministration cannot be avoided, increase the dose of duvelisib on day 12 of coadministration (initial dose, 25 mg orally twice daily increase to 40 mg twice daily; initial dose, 15 mg orally twice daily increase to 25 mg twice daily). After the moderate CYP3A4 inducer has been discontinued for at least 14 days, resume duvelisib at the dose taken prior to initiating the moderate CYP3A4 inducer.
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
Concomitant use of duvelisib (CYP3A4 substrate) with a moderate CYP3A4 inducer decreases duvelisib exposure, which may decrease duvelisib efficacy. Avoid concomitant use of duvelisib and a moderate CP3A4 inducer. If coadministration cannot be avoided, increase the dose of duvelisib on day 12 of coadministration (initial dose, 25 mg orally twice daily, increase to 40 mg twice daily; initial dose, 15 mg orally twice daily, increase to 25 mg twice daily). After the moderate CYP3A4 inducer has been discontinued for at least 14 days, resume duvelisib at the dose taken prior to initiating the moderate CYP3A4 inducer.
Mechanism Of Interaction
Induction of CYP3A4-mediated duvelisib metabolism
Literature Reports
A) Coadministration of etravirine 200 mg twice daily for 12 days (moderate CYP3A inducer) with a single oral 25-mg dose of duvelisib decreased duvelisib Cmax by 16% and AUC by 35% in healthy adults .
Duvelisib Overview
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Duvelisib is used to treat chronic lymphocytic leukemia (CLL; a type of cancer that begins in the white blood cells) or small lymphocytic lymphoma (SLL; a type of cancer that begins mostly in the lymph nodes) that has returned or is unresponsive to at least two other treatments. Duvelisib is in a class of medications called kinase inhibitors. It works by blocking the signals that cause cancer cells to multiply. This helps to stop the spread of cancer cells.
Lorlatinib Overview
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Lorlatinib is used to treat a certain type of non-small cell lung cancer (NSCLC) in adults that has spread to other parts of the body. Lorlatinib is in a class of medications called kinase inhibitors. It works by blocking the action of the abnormal protein that signals cancer cells to multiply. This helps to stop or slow 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:
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.