Panobinostat with Atomoxetine Interaction Details
Brand Names Associated with Panobinostat
- Farydak®
- Panobinostat
Brand Names Associated with Atomoxetine
- Atomoxetine
- Strattera®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Mar 04, 2024
Interaction Effect
Increased CYP2D6 substrate exposure
Interaction Summary
Coadministration of dextromethorphan (a CYP2D6 substrate) with panobinostat (a CYP2D6 inhibitor) caused highly variable increases in dextromethorphan exposure in 1 pharmacokinetic study. Avoid coadministration of panobinostat with sensitive CYP2D6 substrates or CYP2D6 substrates with a narrow therapeutic index, as increased exposure of the CYP2D6 substrate may occur. Frequent monitoring is warranted if coadministration is unavoidable[1].
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
Avoid coadministration of panobinostat (a CYP2D6 inhibitor) with sensitive CYP2D6 substrates or CYP2D6 substrates with a narrow therapeutic index, as increased exposure of the CYP2D6 substrate may occur. Frequent monitoring is warranted if coadministration is unavoidable[1].
Mechanism Of Interaction
Inhibition of CYP2D6-mediated metabolism by panobinostat
Literature Reports
A) Coadministration of dextromethorphan with panobinostat caused highly variable increases in dextromethorphan exposure in 1 pharmacokinetic study. Cmax and AUC of dextromethorphan (a CYP2D6 substrate) increased by 80% (interquartile ranges: 20% to 200%) and 60% (interquartile ranges: 20% to 130%), respectively, from baseline levels in patients with advanced cancer when a single dose was added to an existing panobinostat 20 mg regimen (n=14) [1].
References
1 ) Product Information: FARYDAK(R) oral capsules, panobinostat oral capsules. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2015.
Panobinostat Overview
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Panobinostat is used in combination with bortezomib (Velcade) and dexamethasone to treat people with multiple myeloma (a type of cancer of the bone marrow) who have already been treated two other medications, including bortezomib (Velcade). Panobinostat is in a class of medications called histone deacetylase (HDAC) inhibitors. It works by killing cancer cells.
Atomoxetine Overview
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Atomoxetine is used as part of a total treatment program to increase the ability to pay attention and decrease impulsiveness and hyperactivity in children and adults with ADHD. Atomoxetine is in a class of medications called selective norepinephrine reuptake inhibitors. It works by increasing the levels of norepinephrine, a natural substance in the brain that is needed to control behavior.
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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.