Gefitinib with Vinorelbine Interaction Details
Brand Names Associated with Gefitinib
- Gefitinib
- Iressa®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 27, 2023
Interaction Effect
Increased risk of severe myelotoxicity, particularly neutropenia
Interaction Summary
In a phase II trial, the neutropenic effect of vinorelbine was exacerbated when used concomitantly with gefitinib. In this trial, 4 out of 4 patients experienced severe neutropenia, including 1 death .
Severity
Major
Onset
Delayed
Evidence
Established
How To Manage Interaction
The use of gefitinib and vinorelbine concomitantly has been associated with severe myelotoxicity and should be avoided.
Mechanism Of Interaction
Unknown
Literature Reports
A) In a phase II study evaluating the treatment of non-small cell lung cancer (NSCLC) using the combination of gefitinib and vinorelbine, severe myelotoxicity, particularly severe neutropenia, was documented in all 4 patients enrolled, including 1 death. The study was subsequently closed. Patients had received gefitinib for at least 3 weeks without severe toxicity and had adequate bone marrow, liver, and renal function before vinorelbine was started. The treatment schedule was gefitinib 250 mg/m2 orally daily and vinorelbine 25 mg/m(2) intravenously on days 1 and 8 every 3 weeks. Approximately 1 to 2 weeks after receiving venorelbine, life-threatening neutropenia occurred in all 4 patients, and 1 death was reported. Grade 4 leukopenia, neutropenia, thrombocytopenia, and anemia occurred in 2 (50%), 4 (100%), 1 (25%), and 0 (0%) patients, respectively. The worst neutrophil counts during the first cycles were 48 mm(3) (9th day), 44 mm(3) (14th day), 0 mm(3) (12th day, and 136 mm(3) (16th day) in patients 1, 2, 3, and 4, respectively .
Gefitinib Overview
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Gefitinib is used to treat non-small cell lung cancer that has spread to other parts of the body in people with certain types of tumors. Gefitinib is in a class of medications called kinase inhibitors. It works by blocking the action of a certain naturally occurring substance that may be needed to help cancer cells multiply.
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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.