Fluticasone Propionate with Ivosidenib Interaction Details


Brand Names Associated with Fluticasone Propionate

  • Dymista® Nasal Spray (as a combination product containing Fluticasone, Azelastine)
  • Flonase® Allergy Relief Nasal Spray
  • Flonase® Nasal Spray
  • Flonase® Sensimist Allergy Relief Nasal Spray
  • Fluticasone Nasal Spray
  • Xhance® Nasal Spray

Brand Names Associated with Ivosidenib

  • Ivosidenib
  • Tibsovo®

Medical Content Editor
Last updated Nov 11, 2023


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Interaction Effect

Reduced exposure of sensitive CYP3A4 substrates and risk of loss of efficacy


Interaction Summary

Concomitant use of ivosidenib (CYP3A4 inducer) and a sensitive CYP3A4 substrate may decrease the exposure of the sensitive CYP3A4 substrate and decrease efficacy. Coadministration should be avoided or replaced with alternative therapies. If concomitant use cannot be avoided, monitor patients for lack of therapeutic effect of the sensitive CYP3A4 substrate.


Severity

Major


Onset

Unspecified


Evidence

Theoretical


How To Manage Interaction

Concomitant use of ivosidenib (CYP3A4 inducer) and a sensitive CYP3A4 substrate may decrease the exposure of the sensitive CYP3A4 substrate and decrease efficacy. Coadministration should be avoided or replaced with alternative therapies. If concomitant use cannot be avoided, monitor patients for lack of therapeutic effect of the sensitive CYP3A4 substrate.


Mechanism Of Interaction

Induction of CYP3A4-mediated substrate metabolism by ivosidenib


Literature Reports

A) When a single 375 mg dose of oral aprepitant was administered on Day 9 of a 14-day regimen of 600 mg/day of rifAMPin, a strong CYP3A4 inducer, the AUC of aprepitant decreased approximately 11-fold and the mean terminal half-life decreased approximately 3-fold .

Fluticasone Propionate Overview

  • Nonprescription (over the counter) fluticasone nasal spray is used to relieve symptoms of rhinitis such as sneezing and a runny, stuffy, or itchy nose and itchy, watery eyes caused by hay fever or other allergies (caused by an allergy to pollen, mold, dust, or pets). Prescription fluticasone nasal spray is used to relieve symptoms of nonallergic rhinitis such as sneezing and runny or stuffy nose which are not caused by allergies. Prescription fluticasone nasal spray (Xhance) is used to treat nasal polyps (swelling of the lining of the nose). Fluticasone nasal spray should not be used to treat symptoms (e.g., sneezing, stuffy, runny, itchy nose) caused by the common cold. Fluticasone is in a class of medications called corticosteroids. It works by blocking the release of certain natural substances that cause allergy symptoms.

See More information Regarding Fluticasone Nasal Spray

Ivosidenib Overview

  • Ivosidenib is used to treat a certain type of acute myeloid leukemia (AML; a type of cancer that begins in the white blood cells) that has returned or that has not improved after previous treatment(s). Ivosidenib is also used alone or in combination with azacitidine (Onureg) to treat a certain type of AML in some adults older than 75 years of age as a first treatment. Ivosidenib is also used in adults who have already received previous treatment(s) to treat a certain type of cholangiocarcinoma (bile duct cancer) that has spread to nearby tissues or other parts of the body. Ivosidenib is in a class of medications called IDH1 inhibitors. It works by slowing or stopping the growth of cancer cells.

See More information Regarding Ivosidenib

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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.