Palbociclib with Bosutinib Interaction Details
Brand Names Associated with Palbociclib
- Ibrance®
- Palbociclib
Brand Names Associated with Bosutinib
- Bosulif®
- Bosutinib
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Mar 05, 2024
Interaction Effect
Increased exposure to CYP3A substrates with a narrow therapeutic index
Interaction Summary
Concomitant use of palbociclib (a weak and time-dependent CYP3A inhibitor) and a CYP3A substrate with a narrow therapeutic index (NTI) may increase exposure to and adverse effects of the substrate. During drug interaction studies, coadministration of midazolam with multiple doses of palbociclib resulted in an increase in midazolam AUC and Cmax. Consider dose reductions of the CYP3A substrate if used concomitantly and monitor patients for toxicity[1].
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
Concomitant use of palbociclib (a weak time-dependent CYP3A inhibitor) and a CYP3A substrate with a narrow therapeutic index may increase exposure to and adverse effects of the substrate. Consider dose reductions of the CYP3A substrate if used concomitantly and monitor patients for toxicity[1].
Mechanism Of Interaction
Inhibition of CYP3A substrate metabolism by palbociclib
Literature Reports
A) Coadministration of midazolam (a CYP3A substrate) with multiple doses of palbociclib 125 mg/day in healthy subjects (N=26), resulted in an increase in midazolam AUC and Cmax by 61% and 37%, respectively [1].
References
1 ) Product Information: IBRANCE(R) oral capsules, palbociclib oral capsules. Pfizer Labs (per FDA), New York, NY, 2019.
Palbociclib Overview
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Palbociclib is used in combination with anastrozole (Arimidex), exemestane (Aromasin), or letrozole (Femara) to treat a certain type of hormone receptor–positive, advanced breast cancer (breast cancer that depends on hormones such as estrogen to grow) or breast cancer that has spread to other parts of the body in women who have experienced menopause (change of life; end of monthly menstrual periods) or in men. Palbociclib is also used along with fulvestrant (Faslodex) to treat a certain type of hormone receptor–positive, advanced breast cancer (breast cancer that depends on hormones such as estrogen to grow) or breast cancer that has spread to other parts of the body in people who have been treated with an antiestrogen medication such as tamoxifen (Nolvadex). Palbociclib 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 stop or slow the spread of cancer cells.
Bosutinib Overview
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Bosutinib is used to treat a certain type of chronic myeloid leukemia (CML; a type of cancer of the white blood cells), including treatment in adults who have been recently found to have this condition and in those who can no longer benefit from other medications for CML or who cannot take these medications because of side effects. Bosutinib 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 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:
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.