Sunitinib with Rifapentine Interaction Details
Brand Names Associated with Sunitinib
- Sunitinib
- Sutent®
Brand Names Associated with Rifapentine
- Priftin®
- Rifapentine
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 31, 2023
Interaction Effect
Decreased plasma concentrations of sunitinib and its active metabolite
Interaction Summary
Sunitinib is primarily metabolized by the cytochrome P450 3A4 (CYP3A4) enzyme to its active metabolite, which is also further metabolized by CYP3A4. Coadministration of sunitinib with a CYP3A4 inducer, such as rifapentine, may result in decreased plasma concentrations of sunitinib and its active metabolite. Selection of an alternative to rifapentine, with no or minimal enzyme induction potential is advised. However, if rifapentine is used concurrently, a dose increase for sunitinib is recommended. The dose may be increased in 12.5 milligrams (mg) increments, depending on individual safety and tolerability, to a maximum daily dose of 87.5 mg.
Severity
Major
Onset
Delayed
Evidence
Theoretical
How To Manage Interaction
Due to induction of the cytochrome P450-mediated sunitinib metabolism, concomitant administration of sunitinib and rifapentine may result in decreased plasma concentrations of sunitinib and its active metabolite. Selection of an alternative to rifapentine, with no or minimal enzyme induction potential is advised. However, if rifapentine is used concurrently, consider increasing sunitinib dose in increments of 12.5 milligrams (mg), based on individual safety and tolerability, to a maximum daily dose of 87.5 mg.
Mechanism Of Interaction
Induction of cytochrome P450-mediated sunitinib metabolism
Sunitinib Overview
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Sunitinib is used to treat gastrointestinal stromal tumors (GIST; a type of tumor that grows in the stomach, intestine (bowel), or esophagus (tube that connects the throat with the stomach) in people with tumors that were not treated successfully with imatinib (Gleevec) or people who cannot take imatinib. Sunitinib is also used to treat advanced renal cell carcinoma (RCC, a type of cancer that begins in the cells of the kidneys). Sunitinib is also used to help prevent the return of RCC in people who have RCC that has not spread and have had a kidney removed. Sunitinib is also used to treat pancreatic neuroendocrine tumors (pNET, a type of tumor that begins in certain cells of the pancreas) in people with tumors that have worsened and cannot be treated with surgery. Sunitinib 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 and may help shrink tumors.
Rifapentine Overview
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Rifapentine is used with other medications to treat active tuberculosis (TB; a serious infection that affects the lungs and sometimes other parts of the body) in adults and children 12 years of age and older. Rifapentine is also used with isoniazid (Laniazid) to treat adults and children 2 years of age and older with latent (resting or nongrowing) TB, including those in close contact with people who have active TB, a positive tuberculin skin test, human immunodeficiency virus (HIV), or those with pulmonary fibrosis (scarring of the lungs with an unknown cause). Rifapentine is in a class of medications called antimycobacterials. It works by killing the bacteria that cause infection.
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Antibiotics such as rifapentine will not work for colds, flu, or other viral infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.
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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.