Lurbinectedin Injection and Adagrasib: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Adagrasib
Lurbinectedin Injection
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased lurbinectedin exposure and an increased risk of lurbinectedin-related adverse reactions
Interaction Deep Dive
Avoid concomitant use of lurbinectedin (a CYP3A substrate) with a strong CYP3A inhibitor as it may increase lurbinectedin exposure which may increase the incidence and severity of adverse reactions. Coadministration of itraconazole (a strong CYP3A inhibitor) increased systemic exposure (AUC) of total lurbinectedin by 2.7-fold and unbound lurbinectedin by 2.4-fold. If coadministration cannot be avoided, reduce the dose of lurbinectedin by 50%. After discontinuation of a strong CYP3A inhibitor for 5 half-lives of the inhibitor, increase the lurbinectedin dose to the dose used before starting the inhibitor1.
Why it happens (mechanism)
Inhibition of CYP3A-mediated metabolism of lurbinectedin
Literature reports
1 report — tap to read
a) Coadministration of itraconazole (a strong CYP3A inhibitor) increased systemic exposure (AUC) of total lurbinectedin by 2.7-fold and unbound lurbinectedin by 2.4-fold 1.
Common questions
Can I take Lurbinectedin Injection and Adagrasib together?
Increased lurbinectedin exposure and an increased risk of lurbinectedin-related adverse reactions Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lurbinectedin Injection and Adagrasib interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Lurbinectedin Injection or Adagrasib need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: ZEPZELCA(R) intravenous injection, lurbinectedin intravenous injection. Jazz Pharmaceuticals Inc (per FDA), Palo Alto, CA, 2025. DailyMed
Keep reading about Adagrasib
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